Provider Demographics
NPI:1083732812
Name:DIEHL, DINA RENEE (DO)
Entity Type:Individual
Prefix:DR
First Name:DINA
Middle Name:RENEE
Last Name:DIEHL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13108 DALLAS PKWY STE 430
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-4246
Mailing Address - Country:US
Mailing Address - Phone:469-200-5301
Mailing Address - Fax:469-687-9051
Practice Address - Street 1:13108 DALLAS PKWY STE 430
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-4246
Practice Address - Country:US
Practice Address - Phone:469-200-5301
Practice Address - Fax:469-687-9051
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM9972207R00000X
OH34-008789208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX195297001Medicaid
TXTXB157907Medicare PIN
OH4217041Medicare PIN
TX8L0324Medicare PIN
TX195297001Medicaid
TXTXB157906Medicare PIN