1316142482 NPI number — MS. DIANE TERESE TONEY FNP

Table of content: MS. DIANE TERESE TONEY FNP (NPI 1316142482)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316142482 NPI number — MS. DIANE TERESE TONEY FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TONEY
Provider First Name:
DIANE
Provider Middle Name:
TERESE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
FNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ROBERTS-BROWN
Provider Other First Name:
DIANE
Provider Other Middle Name:
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
FNP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1316142482
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3066 E COMMERCE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN ANTONIO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78220-1013
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-233-7000
Provider Business Mailing Address Fax Number:
210-277-6387

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1102 BARCLAY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78207-7161
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-233-7000
Provider Business Practice Location Address Fax Number:
210-434-1704
Provider Enumeration Date:
06/19/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  AP115949 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 187935502 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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