Diaz De Vivar, Andrea

Diaz De Vivar, Andrea is an individual health care provider with primary practice located at 2525 W Bellfort Street Ste 120, Houston TX 77054-5024. She recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as her primary health care specialty. Diaz De Vivar, Andrea can be contacted via phone (713) 741-6677.

Contact Information

Primary practice address
2525 W Bellfort Street Ste 120 Houston TX 77054-5024
Phone: (713) 741-6677
Fax: (713) 748-5860
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X N2470 Texas

Profile Details

NPI number 1225355845
LBN Legal business name Diaz De Vivar, Andrea
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 21st, 2010
Last updated Mar 30th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225355845 NPPES
Texas MEDICAID 291402006

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