Provider Demographics
NPI:1710257605
Name:DIANA S. DUFF, M.D.
Entity Type:Organization
Organization Name:DIANA S. DUFF, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:S
Authorized Official - Last Name:DUFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-398-8500
Mailing Address - Street 1:701 S FRY RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-2255
Mailing Address - Country:US
Mailing Address - Phone:281-398-8500
Mailing Address - Fax:281-398-8501
Practice Address - Street 1:701 S FRY RD
Practice Address - Street 2:SUITE 100
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-2255
Practice Address - Country:US
Practice Address - Phone:281-398-8500
Practice Address - Fax:281-398-8501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-09
Last Update Date:2012-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK3571207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX030378601Medicaid
TXG68533Medicare UPIN