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Individual

RENEE KUKLA PIETZSCH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DPM

Contact information

Practice address
3007 DAWN DR STE 101, GEORGETOWN, TX 78628-2864
(512) 819-4555
(512) 819-4559
Mailing address
3007 DAWN DR STE 101, GEORGETOWN, TX 78628-2864
(512) 819-4555
(512) 819-4559

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
1667
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
178091801
TX
01
8BD531
BLUE CROSS BLUE SHIELD OF TEXAS
TX
01
P00479025
RAILROAD MEDICARE
TX
Enumeration date
07/02/2006
Last updated
03/19/2026
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