Provider Demographics
NPI:1851856546
Name:DIEBELS, MONIQUE M (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:MONIQUE
Middle Name:M
Last Name:DIEBELS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1181 TEA OLIVE LN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75212-0103
Mailing Address - Country:US
Mailing Address - Phone:208-251-0215
Mailing Address - Fax:
Practice Address - Street 1:4040 BRYCE LN
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75077-7038
Practice Address - Country:US
Practice Address - Phone:940-241-1215
Practice Address - Fax:940-455-2041
Is Sole Proprietor?:No
Enumeration Date:2019-02-06
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1314709225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist