Individual
DIANE L WARMOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
300 UNIVERSITY BLVD BLDG A, ROUND ROCK, TX 78665
(512) 509-0200
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA04035
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
062599802
—
TX
05
—
337171802
—
TX
05
—
337171803
—
TX
Enumeration date
10/04/2005
Last updated
01/25/2022
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