Provider Demographics
NPI:1669480976
Name:CORTINAS, DIANA (MD)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:CORTINAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4745 S JACKSON RD
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-8309
Mailing Address - Country:US
Mailing Address - Phone:956-687-9997
Mailing Address - Fax:956-696-2226
Practice Address - Street 1:4745 S JACKSON RD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-8309
Practice Address - Country:US
Practice Address - Phone:956-687-9997
Practice Address - Fax:956-696-2226
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK7700207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00329061OtherRAILROAD
TX031098902Medicaid
TX8A5054OtherBCBS
TX031098902Medicaid