Individual
DR. PETRA DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
2602 SAN GABRIEL ST, EDINBURG, TX 78539-6951
(956) 624-6755
(956) 380-2971
Mailing address
PO BOX 1950, EDINBURG, TX 78540-1950
(956) 624-6755
(956) 380-2971
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2-2964
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000N41N
PSYCHOLOGIST
TX
05
—
31879479
—
TX
Enumeration date
01/18/2007
Last updated
01/11/2008
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