MEDICARE: DR. THIENDELLA DIAGNE 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	207V00000X	Obstetrics & Gynecology Physician	P0196	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	8CY579	OTHER	TX	BCBS TX

General Provider Information

NPI Number	:	1538330352
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THIENDELLA DIAGNE MD

Provider Business Mailing Address
First Line	:	4422 S MCCOLL RD
Second Line	:
City	:	EDINBURG
State	:	TX
Zip	:	78539-9608
Country	:	US
Telephone Number	:	956-800-4378
Fax Number	:	956-800-4378

Provider Business Practice Location Address
First Line	:	4422 S MCCOLL RD
Second Line	:
City	:	EDINBURG
State	:	TX
Zip	:	78539-9608
Country	:	US
Telephone Number	:	956-800-4378
Fax Number	:	956-800-4379

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

Provider Enumeration Date	:	03/19/2008
Last Update Date	:	04/28/2026

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