Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 581485 | TX |
NPI | 1003917394 |
---|---|
Provider Name | Diana Beckmann-Mendez |
First Address | San Antonio, TX 78229-3901 |
Second Address | San Antonio, TX 78207-0903 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2006 |
Last Update Date | 28/11/2012 |