Provider Demographics
NPI:1265018881
Name:DIAZ-ATHAMNEH, KAREN (LVN)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:DIAZ-ATHAMNEH
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:519 E QUINCY ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78215-1632
Mailing Address - Country:US
Mailing Address - Phone:210-299-1614
Mailing Address - Fax:210-299-4595
Practice Address - Street 1:519 E QUINCY ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78215-1632
Practice Address - Country:US
Practice Address - Phone:210-299-1614
Practice Address - Fax:210-299-4595
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-23
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1964552255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer