Provider Demographics
NPI:1962720144
Name:GHELBER, DIANA (MD)
Entity type:Individual
Prefix:DR
First Name:DIANA
Middle Name:
Last Name:GHELBER
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6800 HARRIS PKWY STE 100B
Mailing Address - Street 2:
Mailing Address - City:FT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76132-4247
Mailing Address - Country:US
Mailing Address - Phone:817-659-7344
Mailing Address - Fax:
Practice Address - Street 1:6800 HARRIS PKWY STE 100
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76132-4247
Practice Address - Country:US
Practice Address - Phone:817-659-7344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-12
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN4425251S00000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No251S00000XAgenciesCommunity/Behavioral Health