Provider Demographics
NPI:1437552502
Name:DIAZ, ALMA DELIA (300265)
Entity Type:Individual
Prefix:
First Name:ALMA
Middle Name:DELIA
Last Name:DIAZ
Suffix:
Gender:F
Credentials:300265
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:736 VIENNA
Mailing Address - Street 2:
Mailing Address - City:EAGLE PASS
Mailing Address - State:TX
Mailing Address - Zip Code:78852-6551
Mailing Address - Country:US
Mailing Address - Phone:830-776-9675
Mailing Address - Fax:
Practice Address - Street 1:736 VIENNA
Practice Address - Street 2:
Practice Address - City:EAGLE PASS
Practice Address - State:TX
Practice Address - Zip Code:78852-6551
Practice Address - Country:US
Practice Address - Phone:830-776-9675
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-03
Last Update Date:2014-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX300265164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse