Preventiamed, PA

NPI #1134344625 in West Lake Hills, Texas

Provider Information

NPI Number: 1134344625
Entity Type: Organization
Organization Name: Preventiamed, PA
Primary Specialty: Internal Medicine
Enumeration Date: Apr 17, 2007
Last Updated: Oct 23, 2010

Practice Location

Address: 1250 S CAPITAL OF TEXAS HWY
Address 2: BUILDING III, SUITE 400
City: West Lake Hills
State: Texas
ZIP Code: 78746-6446
Phone: (512) 308-6349

Authorized Official

Name: DR. DIETER ROBERT MARTIN, M.D.
Title: PRESIDENT
Phone: (512) 308-6349

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Nurse Practitioner	363L00000X
Internal Medicine	207R00000X	Primary

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