Provider Demographics
NPI:1578164695
Name:SAGIROI, DIANA
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:SAGIROI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 TERRACE CREEK CT
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406-3590
Mailing Address - Country:US
Mailing Address - Phone:832-236-0439
Mailing Address - Fax:
Practice Address - Street 1:2000 HOBBS HWY
Practice Address - Street 2:
Practice Address - City:SEMINOLE
Practice Address - State:TX
Practice Address - Zip Code:79360-3039
Practice Address - Country:US
Practice Address - Phone:432-758-3280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-04
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65406183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist