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Contact Information

ANDREA DIAZ DE VIVAR, MD
2525 W BELLFORT STREET
STE 120
HOUSTON, TX77054-5024
 Phone: 713-741-6677
 Fax: 713-748-5860
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anatomic Pathology & Clinical Pathology

207ZP0102X 22 Physician/Pathology
Indicates primary specialty

NPI Profile & details for ANDREA DIAZ DE VIVAR · (Female)

NPI Number 1225355845
Status Active
Credentials MD
Entity Individual
Enumeration date 04/21/2010
Last updated 03/30/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • TX License # N2470
  • TX Medicaid 291402006
Hospital affiliation(s)
  • SAN JACINTO METHODIST HOSPITAL - (Acute Care)
    4401 GARTH ROAD
    BAYTOWN, TX 77521
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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