Individual
DR. CHARLES W. RIETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3600 GASTON AVE, WADLEY TOWER, SUITE 261, DALLAS, TX 75246-1800
(214) 818-9100
(214) 818-9180
Mailing address
3600 GASTON AVE, BARNETT TOWER, SUITE 707, DALLAS, TX 75246-1800
(214) 823-6492
(214) 818-9180
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
E3419
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
81P033
BLUE CROSS BLUE SHIELD
TX
01
—
P00186356
RAILROAD MEDICARE
TX
Enumeration date
06/19/2006
Last updated
08/07/2007
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