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General NPI Number Information
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NPI Number | 1568500916
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Entity Type | Organization
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Legal Business Name | MARTHA DIAZ, O.D., P.C.
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Dates
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Enumeration Date | 02/01/2007
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Last Update Date | 07/02/2009
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Provider Practice Location Address
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Address Line | 3305 ORLANDO ST
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City | HOUSTON
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State | TX
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Zip | 77093-4854
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Country | US
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Telephone | 713-742-5244
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 11998
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City | HOUSTON
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State | TX
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Zip | 77293-1998
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Country | US
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Telephone | 281-467-5524
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARTHA ENRIQUETA DIAZ
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Credential | O.D.
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Telephone | 713-742-5244
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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