MEDICARE: YOLANDA G. DIAZ O. D.

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	152WP0200X	Pediatric Optometrist	5481TG	TX
2	152WV0400X	Vision Therapy Optometrist	5481TG	TX
3	152WC0802X	Corneal and Contact Management Optometrist	5481TG	TX
4	152W00000X	Optometrist	5481TG	TX
5	152WS0006X	Sports Vision Optometrist	5481TG	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

General Provider Information

NPI Number	:	1801969019
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YOLANDA G. DIAZ O. D.

Provider Business Mailing Address
First Line	:	4025 E SOUTHCROSS BLVD STE 26
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78222-3640
Country	:	US
Telephone Number	:	210-932-4922
Fax Number	:	210-932-0047

Provider Business Practice Location Address
First Line	:	4025 E SOUTHCROSS BLVD STE 26
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78222-3640
Country	:	US
Telephone Number	:	210-932-4922
Fax Number	:	210-932-0047

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

Provider Enumeration Date	:	11/16/2006
Last Update Date	:	03/09/2026

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Directions to “ YOLANDA G. DIAZ O. D.” Practice Location

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