Individual
ANGELA J DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, FNP
Contact information
Practice address
3551 ROGER BROOKE DR, FORT SAM HOUSTON, TX 78234-4504
(210) 536-6339
Mailing address
8522 WILD TRCE, GARDEN RIDGE, TX 78266-2219
(210) 240-5724
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
664616
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
219240301
—
TX
01
—
219240302
CSHCN
TX
Enumeration date
09/03/2010
Last updated
10/07/2019
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