Individual
DIANDRA A. GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4502 MEDICAL DR, SAN ANTONIO, TX 78229-4402
(210) 358-2078
(210) 358-1972
Mailing address
4502 MEDICAL DR, SAN ANTONIO, TX 78229-4402
(210) 358-2078
(210) 358-1972
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA11854
TX
Other
Enumeration date
06/01/2018
Last updated
02/05/2024
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