Healthcare Provider Details

I. General information

NPI: 1093807638
Provider Name (Legal Business Name): ALICIA MARIE DIAZ-THOMAS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALICIA DIAZ MD

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 N DUNLAP ST SUITE 230
MEMPHIS TN
38105-4625
US

IV. Provider business mailing address

1155 MILL ST # M14
RENO NV
89502-1576
US

V. Phone/Fax

Practice location:
  • Phone: 901-347-8439
  • Fax:
Mailing address:
  • Phone: 775-982-5262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number024166
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number47280
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD024166
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: