Doctor Name: | MR. MARIO ALBERTO DIAZ |
NPI Number: | 1235461328 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 1000197 |
Business Practice Address: | 2210 N Veterans Blvd Ste 120 Eagle Pass, TX - 788526494 |
Business Phone Number: | 8307579000 |
Business Fax Number: | 8307579002 |
Mailing Address: | 2210 N Veterans Blvd, Ste 120 EAGLE PASS |
State: | TX |
Postal Code: | 788526494 |
Phone Number: | 8307579000 |
Fax Number: | 8307579002 |
NPI Enumeration Date: | 02/01/2010 |
NPI Last Update Date: | 08/02/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | 1000197 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |