Mr John Brett Dietze, MD | |
2602 Saint Michael Dr Ste 302b, Texarkana, TX 75503-5228 | |
(903) 794-4196 | |
(903) 614-5169 |
Full Name | Mr John Brett Dietze |
---|---|
Gender | Male |
Speciality | Neurosurgery |
Experience | 30 Years |
Location | 2602 Saint Michael Dr Ste 302b, Texarkana, Texas |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1588665319 | NPI | - | NPPES |
1G1885 | Other | TX | MEDICARE |
141100101 | Other | INDIGENT HEALTH CARE | |
18796000000 | Other | AR | QUALCHOICE OF ARKANSAS |
98601 | Other | TX | COLLUM & CARNEY CLINIC |
98601 | Other | AR | BLUE CROSS |
179117500 | Other | US DEPT OF LABOR | |
1871793307 | Other | TX | CIGNA DME |
8A0896 | Other | TX | BLUE CROSS |
140006859 | Other | TX | RAILROAD MEDICARE |
141100101 | Medicaid | TX | |
142238001 | Medicaid | AR | |
200023040A | Medicaid | OK | |
5575000001 | Other | TX | CIGNA GOVERNMENT SERVICES |
MDK2152 | Other | TX | WORKERS' COMPENSATION |
98601 | Other | FIRST PYRAMID LIFE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207T00000X | Neurological Surgery | K2152 (Texas) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Providence Health Center | Waco, TX | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Ir Rehab, P.c. | 1153453691 | 126 |
Providence Health Alliance | 6305731068 | 111 |
Entity Name | Christus Trinity Clinic |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1285684225 PECOS PAC ID: 3072426741 Enrollment ID: O20031204001091 |
Entity Name | Providence Health Alliance |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1932210838 PECOS PAC ID: 6305731068 Enrollment ID: O20040220000307 |
Entity Name | C H Wilkinson Physician Network |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1457382947 PECOS PAC ID: 8921919580 Enrollment ID: O20041203000584 |
Mailing Address | Practice Location Address |
---|---|
Mr John Brett Dietze, MD P O Box 9600, Dept 09-019, Texarkana, TX 75505-9600 Ph: (903) 794-4196 | Mr John Brett Dietze, MD 2602 Saint Michael Dr Ste 302b, Texarkana, TX 75503-5228 Ph: (903) 794-4196 |
Mr. Freddie L Contreras, MD Neurological Surgery Medicare: Accepting Medicare Assignments Practice Location: 1002 Texas Blvd, Ste 406, Texarkana, TX 75501 Phone: 903-794-4196 Fax: 903-792-7408 | |
Brian Keith Willis, M.D. Neurological Surgery Medicare: Accepting Medicare Assignments Practice Location: 1002 Texas Blvd Ste 406, Texarkana, TX 75501 Phone: 903-794-4196 Fax: 903-792-7408 |