Provider Demographics
NPI:1306828041
Name:DIAZ, YVONNE (OD)
Entity Type:Individual
Prefix:DR
First Name:YVONNE
Middle Name:
Last Name:DIAZ
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8001 N 10TH ST STE 140
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-9490
Mailing Address - Country:US
Mailing Address - Phone:956-200-2020
Mailing Address - Fax:956-340-4278
Practice Address - Street 1:8001 N 10TH ST STE 140
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-9490
Practice Address - Country:US
Practice Address - Phone:956-200-2020
Practice Address - Fax:956-340-4278
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4965TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX410026155OtherRAILROAD MEDICARE
TX81W361Medicare PIN
TX410026155OtherRAILROAD MEDICARE
TXU50671Medicare UPIN