Individual
DIANA HOULE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
16430 W YUMA RD, GOODYEAR, AZ 85338-3102
(623) 465-6405
Mailing address
16947 W CAMBRIDGE AVE, GOODYEAR, AZ 85395-1926
(623) 215-8140
(757) 490-9401
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
7813
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
084679
—
AZ
01
—
970013900
MEDICARE RAILROAD
—
Enumeration date
08/30/2006
Last updated
09/18/2024
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