Diane Waller, RKT

Primary specialty

KinesiotherapistTaxonomy code 226300000X

License

1383

Practice address

4500 S Lancaster Rd
Dallas, TX 75216-7167

Phone

(817) 385-5949

NPI assigned

Jul 26, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Diane Waller Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412812800000",
    "number": "1982628970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 S LANCASTER RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752167167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 S LANCASTER RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752167167",
            "telephone_number": "817-385-5949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLER",
        "first_name": "DIANE",
        "name_prefix": "Mrs.",
        "credential": "RKT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2014-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "226300000X",
            "taxonomy_group": "",
            "desc": "Kinesiotherapist",
            "state": null,
            "license": "1383",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COPSKT",
            "identifier": "1383",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANE",
            "last_name": "WALLER",
            "credential": "RKT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Tamyra Wallace, FNP
• Terrielle Wallace
• Zachary Wallace, PHARMD
• Erin Wallach, MS CCC-SLP
• David A Waller, MD
• Kaylee Waller, CRNA
• Marcela Waller, CRNA
• Ryan Casey Waller
• Shawn Jillian Waller, PA
• Skylar Wallets

• Kinesiotherapist in Dallas, TX
• Providers in Dallas, TX by specialty
• Kinesiotherapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2014; 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.