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General NPI Number Information
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NPI Number | 1760357578
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Entity Type | Individual
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Provider Name | MARIA OLIVIA DIAZ PTA
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Gender | Female
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Dates
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Enumeration Date | 10/09/2025
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Last Update Date | 10/09/2025
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Provider Practice Location Address
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Address Line | 316 CONQUEST STE 100
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City | EDINBURG
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State | TX
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Zip | 78539-3012
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Country | US
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Telephone | 956-380-6200
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Fax | 956-519-2704
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Provider Business Mailing Address
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Address Line | 2504 E GRIFFIN PKWY
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City | MISSION
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State | TX
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Zip | 78572-3348
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Country | US
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Telephone | 956-519-2700
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Fax | 956-519-2704
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 2077216
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License Number State | TX
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