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Individual

KEVIN JOHN DIETRICH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RN

Contact information

Practice address
4002 LOUETTA RD, SPRING, TX 77388-4405
(832) 717-4083
(281) 655-5234
Mailing address
4002 LOUETTA RD, SPRING, TX 77388-4405
(832) 717-4083
(832) 422-2500

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
TX
251C00000X
Developmentally Disabled Services Day Training Agency
TX
251J00000X
Nursing Care Agency
TX

Other

Enumeration date
01/31/2007
Last updated
03/11/2024
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