Provider Demographics
NPI:1063305704
Name:DIERS, MINA
Entity type:Individual
Prefix:MRS
First Name:MINA
Middle Name:
Last Name:DIERS
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 1:166 HARGRAVES DR
Mailing Address - Street 2:STEC-400 / PMB 345
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78737-4796
Mailing Address - Country:US
Mailing Address - Phone:281-253-2502
Mailing Address - Fax:
Practice Address - Street 1:166 HARGRAVES DR
Practice Address - Street 2:STEC-400 / PMB 345
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78737-4796
Practice Address - Country:US
Practice Address - Phone:281-253-2502
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
No253Z00000XAgenciesIn Home Supportive Care