Diaz, Stefanie M
Diaz, Stefanie M is an individual health care provider with primary practice located at 1133 Medical Dr , Tyler TX 75701-2130. She recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as her primary health care specialty. Diaz, Stefanie M can be contacted via phone (903) 595-5486.Contact Information
Primary practice address
1133 Medical Dr
Tyler TX 75701-2130
Phone: (903) 595-5486
Fax: (903) 595-5128
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Nephrology | 207RN0300X | K8739 | Texas |
Profile Details
| NPI number | 1689723637 |
|---|---|
| LBN Legal business name | Diaz, Stefanie M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 9th, 2007 |
| Last updated | Apr 20th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1689723637 | NPPES |
| Oklahoma | MEDICAID | 200214910 A | |
| Oklahoma | MEDICAID | 040253901 | |
| Oklahoma | Other | 390006572 |
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