Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | L0789 | TX |
NPI | 1003807801 |
---|---|
Provider Name | Dr. Katherine Diase |
First Address | Sugar Land, TEXAS 77479 |
Second Address | Sugar Land, TX 77479-2345 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2005 |
Last Update Date | 25/08/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
148453702 | (05) | TX |
1939678 | CIGNA (01) | TX |
2085936 | FIRST HEALTH/CCN (01) | TX |
7550242 | AETNA (01) | TX |
8P1261 | BCBS (01) | TX |
H49290 | (02) | TX |