MEDICARE: DR. DIANE SUE LITKE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	K4128	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	200038687	OTHER	TX	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8119303003	OTHER	TX	CIGNA
3	1769656	OTHER	TX	UNITED HEALTH CARE
4	4154179	OTHER	TX	BLUE LINK
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	5962564	OTHER	TX	AETNA
7	8558K0	OTHER	TX	BCBS OF TX

General Provider Information

NPI Number	:	1336147867
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DIANE SUE LITKE M.D.

Provider Business Mailing Address
First Line	:	2821 E PRESIDENT GEORGE BUSH HWY STE 201
Second Line	:
City	:	RICHARDSON
State	:	TX
Zip	:	75082-4277
Country	:	US
Telephone Number	:	972-498-4791
Fax Number	:	972-498-4939

Provider Business Practice Location Address
First Line	:	2821 E PRESIDENT GEORGE BUSH HWY STE 201
Second Line	:
City	:	RICHARDSON
State	:	TX
Zip	:	75082-4277
Country	:	US
Telephone Number	:	972-498-4791
Fax Number	:	972-498-4939

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2005
Last Update Date	:	06/11/2024

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Directions to “ DR. DIANE SUE LITKE M.D.” Practice Location

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