MEDICARE: DIANA B. REGGIARDO MD

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
1	208000000X	Pediatrics Physician	H9703	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
12	84679F	OTHER	TX	BLUE CROSS BLUE SHIELD
13	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
14	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386628808
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANA B. REGGIARDO MD

Provider Business Mailing Address
First Line	:	PO BOX 660599
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75266-0599
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6300 HARRY HINES BLVD # 110
Second Line	:	PEDIATRICS PRIMARY CARE CLINIC
City	:	DALLAS
State	:	TX
Zip	:	75235-5259
Country	:	US
Telephone Number	:	214-266-0100
Fax Number	:	214-266-0113

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/30/2005
Last Update Date	:	11/10/2012

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MEDICARE: DIANA B. REGGIARDO MD

Scope of Practice

Other Identifiers

General Provider Information

Similar Medicare Providers

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