Provider Demographics
NPI:1376062562
Name:CHAGOYA, DIANA (AUD)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:CHAGOYA
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5959 S STAPLES ST STE 102
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78413-3844
Mailing Address - Country:US
Mailing Address - Phone:361-854-7000
Mailing Address - Fax:361-814-2685
Practice Address - Street 1:5959 S STAPLES ST STE 102
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78413-3844
Practice Address - Country:US
Practice Address - Phone:361-854-7000
Practice Address - Fax:361-814-2685
Is Sole Proprietor?:No
Enumeration Date:2017-09-19
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81009231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX377713801Medicaid
TX607259YPA9OtherMEDICARE