Alisha Diane Diaz

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

License

PA13170 Issued in TX

Practice address

900 E Southlake Blvd Ste 300
Southlake, TX 76092-6376

Phone

(817) 421-0770

Fax

(817) 421-4759

NPI assigned

Nov 7, 2019

Last updated

Apr 11, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Texas Regional Asthma & Allergy Center

  • Allergy Physician
  • Southlake, TX
  • NPI 1568545739
  NPD

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

{
    "created_epoch": "1573084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649635200000",
    "number": "1609411222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7777 ROYAL LN",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752303711",
            "telephone_number": "210-867-3253",
            "fax_number": "210-692-7833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 E SOUTHLAKE BLVD STE 300",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926376",
            "telephone_number": "817-421-0770",
            "fax_number": "817-421-4759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "ALISHA",
        "middle_name": "DIANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-07",
        "last_updated": "2022-04-11",
        "certification_date": "2022-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA13170",
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "TX",
            "license": "PA13170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• DFW Neuromonitoring Service II, PA
• DFW Neuromonitoring Service, LLC
• DFW Pain Consultants, PLLC
• DFW Surgical Assist, LLC
• Lisa C. Diamond, M.D.
• Sebastian Diaz
• Direct Primed Care PLLC
• Directions Weight Management
• Krystyn Marie Dishaw, DMD, MS
• Diversified Diagnostics

• Allergy & Immunology Physician in Southlake, TX
• Providers in Southlake, TX by specialty
• Allergy & Immunology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2022; 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.