Individual
KIMBERLY I DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA04144
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1366623639
KIMBERLY I. DIAZ, PA-C - NPI
TX
05
—
1366623639
—
TX
01
—
1508813494
GROUP PRACTICE NPI
TX
01
—
741833622
GRP PRACTICE TAX ID
TX
01
—
PA04144
PHYSICIAN ASSISTANT LICENSE
TX
Enumeration date
11/15/2007
Last updated
12/10/2025
Update your record
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