Provider Demographics
NPI:1538330352
Name:DIAGNE, THIENDELLA (MD)
Entity Type:Individual
Prefix:DR
First Name:THIENDELLA
Middle Name:
Last Name:DIAGNE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4422 S MCCOLL RD
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-9608
Mailing Address - Country:US
Mailing Address - Phone:956-800-4378
Mailing Address - Fax:956-800-4378
Practice Address - Street 1:4422 S MCCOLL RD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-9608
Practice Address - Country:US
Practice Address - Phone:956-800-4378
Practice Address - Fax:956-800-4379
Is Sole Proprietor?:No
Enumeration Date:2008-03-19
Last Update Date:2018-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP0196207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX286734301Medicaid
TX8CY579OtherBCBS TX
TXTXB140078Medicare PIN