Provider Demographics
NPI:1932315983
Name:DIETZ, T HAYDEN L (DO)
Entity Type:Individual
Prefix:DR
First Name:T HAYDEN
Middle Name:L
Last Name:DIETZ
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:6300 LA CALMA DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78752-3843
Mailing Address - Country:US
Mailing Address - Phone:512-452-8533
Mailing Address - Fax:512-685-0612
Practice Address - Street 1:6300 LA CALMA DR
Practice Address - Street 2:SUITE 200
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78752-3843
Practice Address - Country:US
Practice Address - Phone:512-452-8533
Practice Address - Fax:512-685-0612
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2013-12-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAOT011316207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine