Provider Demographics
NPI:1003040825
Name:MCPHAIL, DIANE E (MS, CCC/SLP)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:E
Last Name:MCPHAIL
Suffix:
Gender:F
Credentials:MS, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4095 DE ZAVALA RD
Mailing Address - Street 2:
Mailing Address - City:SHAVANO PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78249-2066
Mailing Address - Country:US
Mailing Address - Phone:210-493-8100
Mailing Address - Fax:210-493-8154
Practice Address - Street 1:4095 DE ZAVALA RD
Practice Address - Street 2:
Practice Address - City:SHAVANO PARK
Practice Address - State:TX
Practice Address - Zip Code:78249-2066
Practice Address - Country:US
Practice Address - Phone:210-493-8100
Practice Address - Fax:210-493-8154
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-07
Last Update Date:2009-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19372235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist