Provider Demographics
NPI:1790770394
Name:NOBLE, SYLVIA DIAZ (MD)
Entity Type:Individual
Prefix:DR
First Name:SYLVIA
Middle Name:DIAZ
Last Name:NOBLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1800 BUCKNER ST
Mailing Address - Street 2:SUITE C120
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71101-4440
Mailing Address - Country:US
Mailing Address - Phone:318-227-8899
Mailing Address - Fax:318-222-0407
Practice Address - Street 1:2501 GREENWOOD RD
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71103-3905
Practice Address - Country:US
Practice Address - Phone:318-631-1584
Practice Address - Fax:318-635-8322
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA07301R207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1388939Medicaid
3100023OtherUNITED HEALTHCARE
721404303NO1OtherOCHSNER
TN119451603OtherTEXAS MEDICAID
A006OtherCHAMPUS
LA390005507OtherRAILROAD MEDICARE
LAB65282Medicare UPIN
TN119451603OtherTEXAS MEDICAID