Provider Demographics
NPI:1821611930
Name:HORTON-BARNETT, DIANA
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:HORTON-BARNETT
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 1:4092 TPC PKWY APT 532
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78261-2924
Mailing Address - Country:US
Mailing Address - Phone:281-684-5412
Mailing Address - Fax:
Practice Address - Street 1:6322 FM 78 STE 117
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78244-1033
Practice Address - Country:US
Practice Address - Phone:281-684-5412
Practice Address - Fax:210-277-8783
Is Sole Proprietor?:No
Enumeration Date:2020-05-22
Last Update Date:2020-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX637553163WI0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WI0600XNursing Service ProvidersRegistered NurseInfection Control
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1285160853Medicaid