Organization
WOUND TREATMENT CENTERS OF SOUTH TEXAS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DUANE A DIETZ M.D. (PRESIDENT AND MEDICAL DIRECTOR)
(210) 732-7030
Entity
Organization
Contact information
Practice address
414 NAVARRO ST, SUITE 502, SAN ANTONIO, TX 78205-2516
(210) 223-1145
(210) 615-7619
Mailing address
6800 PARK TEN BLVD, SUITE 266S, SAN ANTONIO, TX 78213-4211
(210) 732-7030
(210) 732-7575
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
H9885
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0019MW
BCBS GROUP IDENTIFIER
TX
Enumeration date
01/31/2007
Last updated
08/22/2020
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