Provider Demographics
NPI:1356633135
Name:DIAZ, SYLVIA (FNP)
Entity Type:Individual
Prefix:
First Name:SYLVIA
Middle Name:
Last Name:DIAZ
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2155 PAREDES LINE RD
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78521-1609
Mailing Address - Country:US
Mailing Address - Phone:956-296-2925
Mailing Address - Fax:956-296-2920
Practice Address - Street 1:2155 PAREDES LINE RD
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521-1609
Practice Address - Country:US
Practice Address - Phone:956-296-2925
Practice Address - Fax:956-296-2920
Is Sole Proprietor?:No
Enumeration Date:2011-05-11
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX616902163WG0000X
TXAP119400363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH08PA22501OtherBCBS
TX3544835-04Medicaid