Basic Information
| Provider Information | |||||||||
| NPI: | 1932265774 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DIAMOND | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | S | ||||||||
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| OtherLastName: | DIAMOND | ||||||||
| OtherFirstName: | DAVID | ||||||||
| OtherMiddleName: | S | ||||||||
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| OtherCredential: | DO | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 5224 SUN MEADOW DR | ||||||||
| Address2: | |||||||||
| City: | FLOWER MOUND | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750225680 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8173292502 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1650 WEST COLLEGE AVE | ||||||||
| Address2: | BAYLOR MEDICAL CENTER GRAPEVINE | ||||||||
| City: | GRAPEVINE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 76051 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8174811588 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/28/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | K5901 | TX | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.