MEDICARE: ALIANET DIAZ ENRIQUEZ NP

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	163W00000X	Registered Nurse	779601	NY
2	163W00000X	Registered Nurse	981148	TX
3	363LF0000X	Family Nurse Practitioner	1168772	TX

General Provider Information

NPI Number	:	1477190734
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALIANET DIAZ ENRIQUEZ NP

Provider Business Mailing Address
First Line	:	12531 FLEET RIVER RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77047-2211
Country	:	US
Telephone Number	:	832-766-9006
Fax Number	:

Provider Business Practice Location Address
First Line	:	15825 BELLAIRE BLVD STE D
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77083-2347
Country	:	US
Telephone Number	:	832-328-1911
Fax Number	:	832-328-1912

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

Provider Enumeration Date	:	12/05/2019
Last Update Date	:	07/12/2024

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