Provider Demographics
NPI:1396772737
Name:DIAMOND, HOWARD G (MD)
Entity type:Individual
Prefix:
First Name:HOWARD
Middle Name:G
Last Name:DIAMOND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3201 E PRESIDENT GEORGE BUSH HWY STE 107
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082-3565
Mailing Address - Country:US
Mailing Address - Phone:214-530-8400
Mailing Address - Fax:214-691-2967
Practice Address - Street 1:3201 E PRESIDENT GEORGE BUSH HWY STE 107
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75082-3565
Practice Address - Country:US
Practice Address - Phone:214-530-8400
Practice Address - Fax:214-691-2967
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2009-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH4283208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F20815Medicare PIN
TX8F20810Medicare PIN
TXE04480Medicare UPIN
TX8F20820Medicare PIN