Provider Demographics
NPI:1851622815
Name:DUMAS, DIANA GUADALUPE
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:GUADALUPE
Last Name:DUMAS
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 1:7114 N ORACLE RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-4332
Mailing Address - Country:US
Mailing Address - Phone:520-297-2826
Mailing Address - Fax:520-297-4590
Practice Address - Street 1:7114 N ORACLE RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-4332
Practice Address - Country:US
Practice Address - Phone:520-297-2826
Practice Address - Fax:520-297-4590
Is Sole Proprietor?:No
Enumeration Date:2010-01-14
Last Update Date:2010-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS08094183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist