Individual provider Active NPI

Diana Vargas Huckaby, FNP

  • Family Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1902355977
Registry record updated Aug 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP131798 Issued in TX
Practice address
5107 Medical Dr
San Antonio, TX 78229-4801
Phone
(210) 614-8612
NPI assigned
Sep 30, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP131798 TX Primary

Addresses

Primary practice location

5107 Medical Dr
San Antonio, TX 78229-4801

Mailing address

1269 Pelican PL
New Braunfels, TX 78130-7066
Phone (210) 313-2219

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170330000202 TX Practitioner - Nurse Practitioner 1456636687 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP131798TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Diabetes and Glandular Disease Clinic PA CurrentSince Jan 3, 2017 Accepting new patients

Locations

5107 Medical Dr
San Antonio, TX 78229
Phone (210) 614-8612

5107 Medical Dr
Ste 100
San Antonio, TX 78229

Interoperability endpoints

  • Direct secure messaging: diana.huckaby.1@18380.direct.athenahealth.com

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1475193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692835200000",
    "number": "1902355977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1269 PELICAN PL",
            "city": "NEW BRAUNFELS",
            "state": "TX",
            "postal_code": "781307066",
            "telephone_number": "210-313-2219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5107 MEDICAL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294801",
            "telephone_number": "210-614-8612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUCKABY",
        "first_name": "DIANA",
        "middle_name": "VARGAS",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-30",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP131798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.