Individual
JULIE DIECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1500 COOPER ST, FORT WORTH, TX 76104-2710
(682) 885-6400
(682) 885-6101
Mailing address
PO BOX 99371, FORT WORTH, TX 76199-0371
(682) 885-1855
(682) 885-7347
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
110510
TN
Other
Enumeration date
08/10/2015
Last updated
08/10/2015
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