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General NPI Number Information
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NPI Number | 1336084128
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Entity Type | Individual
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Provider Name | DIANA NICOLE PEREZ
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Gender | Female
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Dates
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Enumeration Date | 04/20/2026
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Last Update Date | 04/20/2026
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Provider Practice Location Address
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Address Line | 18 SCENIC LOOP RD # 200D
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City | BOERNE
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State | TX
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Zip | 78006-8672
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Country | US
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Telephone | 830-755-0098
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Fax | 830-327-0099
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Provider Business Mailing Address
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Address Line | 3838 LOCKHILL SELMA RD APT 313
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City | SAN ANTONIO
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State | TX
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Zip | 78230-1570
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Country | US
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Telephone | 830-755-0098
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Fax | 830-327-0099
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 123728
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License Number State | TX
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