Individual
JOHN ANTHONY DIECK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
G8081
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060012108
MEDICARE RAILROAD
TX
05
—
131632501
—
TX
05
—
131632507
—
TX
05
—
131632508
—
TX
01
—
8BX076
BCBSTX
TX
01
—
P00700180
MEDICARE RAILROAD
TX
01
—
P00706404
RAILROAD MEDICARE
TX
Enumeration date
08/02/2005
Last updated
06/24/2011
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