Healthcare Provider Details

I. General information

NPI: 1326884347
Provider Name (Legal Business Name): MONIKA DIAZ PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2024
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2631 GATTIS SCHOOL RD STE 405
ROUND ROCK TX
78664-2822
US

IV. Provider business mailing address

2631 GATTIS SCHOOL RD STE 405
ROUND ROCK TX
78664-2822
US

V. Phone/Fax

Practice location:
  • Phone: 737-320-8109
  • Fax:
Mailing address:
  • Phone: 737-320-8109
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number41036
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: