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NPI Code Detail

MEDICARE: DIEDRA LEE HART

MEDICARE:   DIEDRA LEE HART
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
1390200000XStudent in an Organized Health Care Education/Training Program1163587TX

General Provider Information

NPI Number : 1295698389
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIEDRA LEE HART
Provider Business Mailing Address
First Line : 8200 SOUTHWESTERN BLVD APT 1807
Second Line :
City : DALLAS
State : TX
Zip : 75206-2125
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5200 HARRY HINES BLVD
Second Line :
City : DALLAS
State : TX
Zip : 75235-7709
Country : US
Telephone Number : 214-590-8000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2025
Last Update Date : 01/15/2026

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Directions to “ DIEDRA LEE HART ” Practice Location

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