Individual
MARIA LINDA DIESTRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2548 MEMORIAL BLVD, PORT ARTHUR, TX 77640-2825
(409) 983-1161
(409) 983-4933
Mailing address
2548 MEMORIAL BLVD, PORT ARTHUR, TX 77640-2825
(409) 983-1161
(409) 983-4933
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
451821
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
126826002
—
TX
Enumeration date
07/15/2005
Last updated
08/02/2011
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