Healthcare Provider Details

I. General information

NPI: 1679395982
Provider Name (Legal Business Name): THOMAS A DIETZ NP PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2024
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2828 LOTUS PARK
SCHERTZ TX
78154-3740
US

IV. Provider business mailing address

PO BOX 360
SCHERTZ TX
78154-0360
US

V. Phone/Fax

Practice location:
  • Phone: 210-239-3009
  • Fax: 210-405-9994
Mailing address:
  • Phone: 210-239-3009
  • Fax: 210-405-9994

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: THOMAS A DIETZ
Title or Position: AUTHORIZED OFFICIAL
Credential: PMHNP-BC
Phone: 210-239-3009