Diamond Blue Sports and Health LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

DIAMOND BLUE SPORTS AND HEALTH LLC

Doing business as

Blue Diamond Med Spa

Practice address

104 Gallery Cir Ste 126
San Antonio, TX 78258-3338

Phone

(210) 494-2820

NPI assigned

Jul 22, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Veronica Kereti

Title

Owner

Phone

(210) 494-2820

Specialties & licenses 1

Addresses

Other names 1

• Blue Diamond Med Spa Doing business as

Electronic endpoints 2

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1626912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626912000000",
    "number": "1487227872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 GALLERY CIR STE 126",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782583338",
            "telephone_number": "210-494-2820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 GALLERY CIR STE 126",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782583338",
            "telephone_number": "210-494-2820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIAMOND BLUE SPORTS AND HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-22",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-21",
        "status": "A",
        "authorized_official_last_name": "KERETI",
        "authorized_official_first_name": "VERONICA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "210-494-2820"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "veronica@bluediamondmedspa.com",
            "affiliation": "N",
            "endpointDescription": "E-mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "104 Gallery Cir Ste 126",
            "city": "San Antonio",
            "state": "TX",
            "country_code": "US",
            "postal_code": "782583338",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "bluediamondmedspa.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "address_1": "104 Gallery Cir Ste 126",
            "city": "San Antonio",
            "state": "TX",
            "country_code": "US",
            "postal_code": "782583338",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Blue Diamond Med Spa",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Diagnostic and Natural Health Center, P.a.
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• Martha Sue Dial, LPC, LMFT
• Souleymane Yaya Diallo, D.O.
• Dialysis Clinic Inc.
• Jason Diamond, PHARM.D.
• Lisa Deanne Diamond, CHIRO. ASSISTANT
• Susan A. Diamond, M.D.
• Diana Gonzalez, OD, & Associates, PA
• Diana R. Galvan, PLLC

• Clinic/Center in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.