Healthcare Provider Details

I. General information

NPI: 1528581329
Provider Name (Legal Business Name): DIANA BORDERS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2017
Last Update Date: 07/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4120 COLINA AVE
DENTON TX
76210-4629
US

IV. Provider business mailing address

305 E FM 1830
ARGYLE TX
76226-4317
US

V. Phone/Fax

Practice location:
  • Phone: 940-391-7274
  • Fax: 214-773-9974
Mailing address:
  • Phone: 972-653-2229
  • Fax: 866-941-5104

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WN0003X
TaxonomyLow-Risk Neonatal Registered Nurse
License Number627026
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number627026
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: