Active NPI
Diana West
- Physical Therapy Assistant
- Dallas, TX
National Provider Identifier
1861164006
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2165417
- Practice address
- 14651 Dallas Pkwy Ste 200
Dallas, TX 75254-8856 - Phone
- (866) 919-3240
- NPI assigned
- Oct 5, 2021
- 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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2165417 | TX | Primary |
Addresses
Primary practice location
14651 Dallas Pkwy Ste 200
Dallas, TX 75254-8856
Mailing address
2001 E Spring Creek Pkwy Apt 5107
Plano, TX 75074-3247
Phone (502) 554-2366
Other names 1
- Diana Wallace
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 |
|---|---|---|---|
| 2165417 | TX | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1633392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1633392000000",
"number": "1861164006",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2001 E SPRING CREEK PKWY APT 5107",
"city": "PLANO",
"state": "TX",
"postal_code": "750743247",
"telephone_number": "502-554-2366"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14651 DALLAS PKWY STE 200",
"city": "DALLAS",
"state": "TX",
"postal_code": "752548856",
"telephone_number": "866-919-3240"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEST",
"first_name": "DIANA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-10-05",
"last_updated": "2021-10-05",
"certification_date": "2021-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "TX",
"license": "2165417",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "DIANA",
"last_name": "WALLACE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 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.