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General NPI Number Information
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NPI Number | 1740404862
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Entity Type | Individual
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Provider Name | THELMA E DIAZ NP
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Gender | Female
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 04/22/2024
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Provider Practice Location Address
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Address Line | 1626 MEDICAL CENTER DR STE 400 4TH FLOOR
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City | EL PASO
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State | TX
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Zip | 79902-5000
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Country | US
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Telephone | 915-546-9200
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Fax | 915-546-9800
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Provider Business Mailing Address
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Address Line | 1626 MEDICAL CENTER DR STE 400 4TH FLOOR
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City | EL PASO
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State | TX
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Zip | 79902-5000
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Country | US
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Telephone | 915-546-9200
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Fax | 915-546-9800
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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 | 163WW0000X
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Taxonomy Name | Wound Care Registered Nurse
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License Number | AP107026
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207PE0005X
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Taxonomy Name | Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
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License Number | AP107026
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 584935
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License Number State | TX
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