Provider Demographics
NPI:1982154175
Name:CHAVEZ, DIANA CHOY (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:CHOY
Last Name:CHAVEZ
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 961205
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76161-1205
Mailing Address - Country:US
Mailing Address - Phone:817-740-8450
Mailing Address - Fax:817-378-3699
Practice Address - Street 1:2225 VATICAN LN
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75224-4719
Practice Address - Country:US
Practice Address - Phone:214-333-3393
Practice Address - Fax:214-333-0809
Is Sole Proprietor?:No
Enumeration Date:2016-10-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP132166363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner