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NPI Code Detail

MEDICARE: KEVIN D DIAMOND MD

MEDICARE: KEVIN D DIAMOND 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
1208800000XUrology PhysicianL4338TX

General Provider Information

NPI Number : 1790771897
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEVIN D DIAMOND MD
Provider Business Mailing Address
First Line : PO BOX 733784
Second Line :
City : DALLAS
State : TX
Zip : 75373-3784
Country : US
Telephone Number : 682-885-6483
Fax Number : 682-885-3113
Provider Business Practice Location Address
First Line : 750 8TH AVE FL 6
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-2515
Country : US
Telephone Number : 682-303-0376
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2005
Last Update Date : 09/25/2024

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Directions to “ KEVIN D DIAMOND MD” Practice Location

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