Individual
DUSTIN WAYNE JANZEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LSA
Contact information
Practice address
2967 OAK RUN PKWY STE 505, NEW BRAUNFELS, TX 78132-5379
(210) 598-2800
Mailing address
2967 OAK RUN PKWY, STE 505, RM #12, NEW BRAUNFELS, TX 78132-5379
(210) 598-2800
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
SA00555
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1234
CERTIFICATION - OPA-C
TX
01
—
154639
NBSTSA BOARD CERTIFICATION
TX
01
—
SA00555
LSA LICENSE
TX
Enumeration date
09/12/2014
Last updated
03/21/2022
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