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NPI Code Detail

MEDICARE: DIANA WAKE AU.D.

MEDICARE:   DIANA  WAKE  AU.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1231H00000XAudiologist81846TX

General Provider Information

NPI Number : 1215867981
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIANA WAKE AU.D.
Provider Business Mailing Address
First Line : 109 AKELA WAY
Second Line :
City : GEORGETOWN
State : TX
Zip : 78626-2735
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6611 RIVER PLACE BLVD STE 301
Second Line :
City : AUSTIN
State : TX
Zip : 78730-1162
Country : US
Telephone Number : 512-677-6368
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2026
Last Update Date : 05/22/2026

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Directions to “ DIANA WAKE AU.D.” Practice Location

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