Provider Demographics
NPI:1841633377
Name:DIAHN, VIVIAN T
Entity type:Individual
Prefix:
First Name:VIVIAN
Middle Name:T
Last Name:DIAHN
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 1:22803 NORTHRIDGE TERRACE CT
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77373-5685
Mailing Address - Country:US
Mailing Address - Phone:281-723-9442
Mailing Address - Fax:877-773-4140
Practice Address - Street 1:22803 NORTHRIDGE TERRACE CT
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77373-5685
Practice Address - Country:US
Practice Address - Phone:281-723-9442
Practice Address - Fax:877-773-4140
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-15
Last Update Date:2013-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor