Provider Demographics
NPI:1932265774
Name:DIAMOND, DAVID S
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:S
Last Name:DIAMOND
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:DAVID
Other - Middle Name:S
Other - Last Name:DIAMOND
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:5224 SUN MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75022-5680
Mailing Address - Country:US
Mailing Address - Phone:817-329-2502
Mailing Address - Fax:
Practice Address - Street 1:1650 WEST COLLEGE AVE
Practice Address - Street 2:BAYLOR MEDICAL CENTER GRAPEVINE
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051
Practice Address - Country:US
Practice Address - Phone:817-481-1588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK5901207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine