Organization Active NPI

Darrell R. Pietsch, M.D, P.a.

  • Family Medicine Physician
  • Waco, TX
National Provider Identifier
1225548795
Registry record updated Oct 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
K7867 Issued in TX
Legal business name
DARRELL R. PIETSCH, M.D, P.A.
Practice address
6600 Fish Pond Rd
Waco, TX 76710-2581
Phone
(254) 732-6789
NPI assigned
Oct 10, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Darrell Ray Pietsch, MD
Title
President
Phone
(254) 732-6789

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X K7867 TX Primary

Addresses

Primary practice location

6600 Fish Pond Rd
Waco, TX 76710-2581

Mailing address

6600 Fish Pond Rd
Waco, TX 76710-2581
Phone (254) 732-6789

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1507593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507593600000",
    "number": "1225548795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 FISH POND RD",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767102581",
            "telephone_number": "254-732-6789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 FISH POND RD",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767102581",
            "telephone_number": "254-732-6789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DARRELL R. PIETSCH, M.D, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-10",
        "last_updated": "2017-10-10",
        "status": "A",
        "authorized_official_last_name": "PIETSCH",
        "authorized_official_first_name": "DARRELL",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "254-732-6789",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K7867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.