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General NPI Number Information
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NPI Number | 1093807638
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Entity Type | Individual
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Provider Name | ALICIA MARIE DIAZ-THOMAS MD
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Gender | Female
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Dates
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Enumeration Date | 09/29/2006
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Last Update Date | 10/08/2025
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Provider Practice Location Address
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Address Line | 51 N DUNLAP ST SUITE 230
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City | MEMPHIS
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State | TN
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Zip | 38105-4625
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Country | US
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Telephone | 901-347-8439
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Fax |
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Provider Business Mailing Address
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Address Line | 1155 MILL ST # M14
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City | RENO
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State | NV
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Zip | 89502-1576
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Country | US
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Telephone | 775-982-5262
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 024166
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 2080P0205X
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Taxonomy Name | Pediatric Endocrinology Physician
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License Number | 47280
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD024166
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License Number State | LA
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