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Individual

KIMBERLY I DIAZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
7323 MARBACH RD STE 104, SAN ANTONIO, TX 78227-1905
(210) 674-0257
(210) 369-9064
Mailing address
7323 MARBACH RD STE 104, SAN ANTONIO, TX 78227-1905
(210) 674-0257
(210) 369-9064

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
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