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General NPI Number Information
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NPI Number | 1194988642
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Entity Type | Individual
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Provider Name | GABRIEL J BIETZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/04/2008
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Last Update Date | 11/04/2025
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Provider Practice Location Address
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Address Line | 7402 JOHN SMITH DR STE 101
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City | SAN ANTONIO
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State | TX
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Zip | 78229-4588
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Country | US
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Telephone | 210-817-4848
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Fax | 210-257-6949
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Provider Business Mailing Address
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Address Line | 5224 75TH ST STE D
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City | LUBBOCK
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State | TX
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Zip | 79424-2525
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Country | US
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Telephone | 806-712-1096
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Fax | 806-771-2093
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 44238
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | P3290
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License Number State | TX
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