Provider Demographics
NPI:1174875231
Name:VASQUEZ, DIANA (DPT)
Entity type:Individual
Prefix:DR
First Name:DIANA
Middle Name:
Last Name:VASQUEZ
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:DR
Other - First Name:DIANA
Other - Middle Name:ANDREA
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:7007 N 10TH ST
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-3104
Mailing Address - Country:US
Mailing Address - Phone:956-661-0475
Mailing Address - Fax:956-661-0482
Practice Address - Street 1:7007 N 10TH ST
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-3104
Practice Address - Country:US
Practice Address - Phone:956-661-0475
Practice Address - Fax:956-661-0482
Is Sole Proprietor?:No
Enumeration Date:2012-10-12
Last Update Date:2017-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1221957225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist