Organization
JONATHAN M KLETZ DPM P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN MARK KLETZ DPM (PRESIDENT)
(214) 340-8885
Entity
Organization
Contact information
Practice address
514 E CORISICANA ST STE B, ATHENS, TX 75751-2506
(909) 677-9090
(903) 677-9091
Mailing address
6760 ABRAMS RD, STE 203, DALLAS, TX 75231-0246
(214) 340-8885
(214) 340-4046
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
1102
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120518901
—
TX
Enumeration date
02/27/2008
Last updated
04/24/2008
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