Individual
WILLIAM E DIETZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
115 AIRPORT RD, SULPHUR SPRINGS, TX 75482-2105
(903) 438-4670
(903) 885-8720
Mailing address
PO BOX 846098, DALLAS, TX 75284-6098
(903) 324-6400
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
D4092
TX
207Y00000X
Otolaryngology Physician
Primary
D4092
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
089557503
—
TX
01
—
75-2616977-113
TRICARE
TX
Enumeration date
06/16/2005
Last updated
09/26/2018
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