Individual
DIANA B. REGGIARDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6300 HARRY HINES BLVD # 110, PEDIATRICS PRIMARY CARE CLINIC, DALLAS, TX 75235-5259
(214) 266-0100
(214) 266-0113
Mailing address
PO BOX 660599, DALLAS, TX 75266-0599
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
H9703
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
119089403
—
TX
05
—
119089405
—
TX
05
—
119089408
—
TX
05
—
119089409
—
TX
05
—
119089411
—
TX
05
—
119089412
—
TX
05
—
119089414
—
TX
05
—
119089415
—
TX
05
—
119089416
—
TX
05
—
119089417
—
TX
05
—
119089418
—
TX
05
—
119089419
—
TX
05
—
119089422
—
TX
01
—
84679F
BLUE CROSS BLUE SHIELD
TX
Enumeration date
11/30/2005
Last updated
11/10/2012
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