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Individual

ALISHA DIANE DIAZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
900 E SOUTHLAKE BLVD STE 300, SOUTHLAKE, TX 76092-6376
(817) 421-0770
(817) 421-4759
Mailing address
7777 ROYAL LN, DALLAS, TX 75230-3711
(210) 867-3253
(210) 692-7833

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
PA13170
TX
363A00000X
Physician Assistant
PA13170
TX

Other

Enumeration date
11/07/2019
Last updated
04/11/2022
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