Active NPI
Elvia Guadalupe Diaz, COTA
- Community Health Worker
- San Antonio, TX
National Provider Identifier
1750638813
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- License
- 200586
- Practice address
- 9505 Fredericksburg Rd
San Antonio, TX 78240-4284 - Phone
- (210) 272-0319
- Fax
- (210) 272-0324
- NPI assigned
- Aug 8, 2012
- 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 |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | 200586 | TX | Primary |
Addresses
Primary practice location
9505 Fredericksburg Rd
San Antonio, TX 78240-4284
Mailing address
9505 Fredericksburg Rd
San Antonio, TX 78240-4284
Phone (210) 272-0319
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 200586 | TX | MD | Community Health Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1344384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344384000000",
"number": "1750638813",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9505 FREDERICKSBURG RD",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782404284",
"telephone_number": "210-272-0319",
"fax_number": "210-272-0324"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9505 FREDERICKSBURG RD",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782404284",
"telephone_number": "210-272-0319",
"fax_number": "210-272-0324"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIAZ",
"first_name": "ELVIA",
"middle_name": "GUADALUPE",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-08-08",
"last_updated": "2012-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "TX",
"license": "200586",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.