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General NPI Number Information
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NPI Number | 1285506097
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Entity Type | Individual
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Provider Name | STEPHANIE DIANA BAQUERIZO RDMS
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Gender | Female
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Dates
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Enumeration Date | 09/22/2025
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Last Update Date | 09/22/2025
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Provider Practice Location Address
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Address Line | 1400 N COIT RD STE 601
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City | MCKINNEY
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State | TX
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Zip | 75071-6658
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Country | US
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Telephone | 682-241-6854
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Fax |
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Provider Business Mailing Address
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Address Line | 1809 PLEASANT KNOLL TRL
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City | AUBREY
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State | TX
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Zip | 76227-2682
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Country | US
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Telephone | 214-604-4972
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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 | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number | 143109
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License Number State | TX
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