Organization
JOHN A DIECK PA
Active
Other names
Texas Heart & Vascular PA
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN A DIECK JR. M.D. (PRESIDENT)
(512) 623-5300
Entity
Organization
Contact information
Practice address
4316 JAMES CASEY ST, BLDG. A, AUSTIN, TX 78745-1157
(512) 623-5300
(512) 623-5399
Mailing address
PO BOX 13045, AUSTIN, TX 78711-3045
(512) 623-5300
(512) 623-5399
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
G8081
TX
207RC0000X
Cardiovascular Disease Physician
Primary
G8081
TX
207RC0001X
Clinical Cardiac Electrophysiology Physician
G8081
TX
207RI0011X
Interventional Cardiology Physician
G8081
TX
207UN0901X
Nuclear Cardiology Physician
G8081
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0089RZ
BCBSTX GROUP NUMBER
TX
05
—
197564101
—
TX
05
—
197564102
—
TX
01
—
DO6808
MEDICARE RAILROAD
TX
Enumeration date
06/18/2008
Last updated
04/14/2010
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