Provider Demographics
NPI:1386246189
Name:MORRIS, DIANA LYNN
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:LYNN
Last Name:MORRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25145 PANTHER BEND CT UNIT 2401
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77380-3781
Mailing Address - Country:US
Mailing Address - Phone:281-628-0535
Mailing Address - Fax:
Practice Address - Street 1:26270 NORTHWEST FWY
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-1761
Practice Address - Country:US
Practice Address - Phone:281-304-9664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX43796183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist