MEDICARE: DR. DIANE MARILEE GARD PHD

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	103T00000X	Psychologist	2264	CO
2	103TC0700X	Clinical Psychologist	33829	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	614301	OTHER	TX	MEDICARE B

General Provider Information

NPI Number	:	1831264274
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DIANE MARILEE GARD PHD

Provider Business Mailing Address
First Line	:	PO BOX 2107
Second Line	:
City	:	MABANK
State	:	TX
Zip	:	75147-5017
Country	:	US
Telephone Number	:	903-368-2299
Fax Number	:	903-489-0111

Provider Business Practice Location Address
First Line	:	122 S GUN BARREL LN
Second Line	:	SUITE 6
City	:	GUN BARREL CITY
State	:	TX
Zip	:	75156-9403
Country	:	US
Telephone Number	:	903-887-0697
Fax Number	:	903-887-0698

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

Provider Enumeration Date	:	11/21/2006
Last Update Date	:	02/22/2012

Similar Medicare Providers

1114285970 — EAST TEXAS NEUROBEHAVIORAL HEALTH,PLLC
Practice Location Address:

122 S GUN BARREL LN , SUITE 6
GUN BARREL CITY, TX
75156-9403

Practice Phone: 903-887-0697
Practice Fax: 903-887-0698

1609958560 — MRS. LEIGHANNE B MCGOWAN RN
Practice Location Address:

91648 RIVER RD
JUNCTION CITY, OR
97448-9403

Practice Phone: 503-319-2426
Practice Fax: 541-461-2498

1235351990 — MS. JOHNNIE WILLENE ROGERS LPN
Practice Location Address:

12601 N PENNSYLVANIA AVE APT 121
OKLAHOMA CITY, OK
73120-9403

Practice Phone: 405-525-2525
Practice Fax: 405-525-3108

1801119946 — FRANK JOSEPH PIOTROWSKI RPH
Practice Location Address:

173 PLEASANT MOUNT DR
FOREST CITY, PA
18421-9403

Practice Phone: 570-785-9888
Practice Fax: 570-785-9888

1699145656 — TARSHA CRUMMEDYO
Practice Location Address:

9403 CHURCHLAKE CIR
MISSOURI CITY, TX
77459-1694

Practice Phone: 713-398-1949
Practice Fax:

1801240437 — MEGAN PRESTON
Practice Location Address:

9403 N GRANBY AVE
KANSAS CITY, MO
64154-1383

Practice Phone: 816-258-3129
Practice Fax:

Directions to “ DR. DIANE MARILEE GARD PHD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.