Active NPI
Peggy Ann Diaz, LCSW
- Clinical Social Worker
- San Marcos, TX
National Provider Identifier
1053480228
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 19567
- Practice address
- 151 Stagecoach TRL Ste 220
San Marcos, TX 78666-3863 - Phone
- (448) 248-7758
- Fax
- (281) 648-2200
- NPI assigned
- Nov 6, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 19567 | TX | Primary |
Addresses
Primary practice location
151 Stagecoach TRL Ste 220
San Marcos, TX 78666-3863
Mailing address
151 Stagecoach TRL Ste 220
San Marcos, TX 78666-3863
Phone (448) 248-7758
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00S99W | Medicaid | TX | |
| 87256Q | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19567 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675900800000",
"number": "1053480228",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "151 STAGECOACH TRL STE 220",
"city": "SAN MARCOS",
"state": "TX",
"postal_code": "786663863",
"telephone_number": "448-248-7758",
"fax_number": "281-648-2200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "151 STAGECOACH TRL STE 220",
"city": "SAN MARCOS",
"state": "TX",
"postal_code": "786663863",
"telephone_number": "448-248-7758",
"fax_number": "281-648-2200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIAZ",
"first_name": "PEGGY",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-06",
"last_updated": "2023-02-09",
"certification_date": "2023-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "19567",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00S99W",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "87256Q",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Marcos, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.