Individual
MR. JOHN BRETT DIETZE
Active
Individual
MR. JOHN BRETT DIETZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
K2152
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
140006859
RAILROAD MEDICARE
TX
01
—
141100101
INDIGENT HEALTH CARE
—
05
—
141100101
—
TX
05
—
142238001
—
AR
01
—
179117500
US DEPT OF LABOR
—
01
—
1871793307
CIGNA DME
TX
01
—
18796000000
QUALCHOICE OF ARKANSAS
AR
01
—
1G1885
MEDICARE
TX
05
—
200023040A
—
OK
01
—
5575000001
CIGNA GOVERNMENT SERVICES
TX
01
—
8A0896
BLUE CROSS
TX
01
—
98601
BLUE CROSS
AR
01
—
98601
COLLUM & CARNEY CLINIC
TX
01
—
98601
FIRST PYRAMID LIFE
—
01
—
MDK2152
WORKERS' COMPENSATION
TX
Enumeration date
08/02/2005
Last updated
04/28/2021
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