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NPI Code Detail

MEDICARE: JONATHAN MICHAEL DIAZ M.A

MEDICARE: JONATHAN MICHAEL DIAZ M.A
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor93776TX

General Provider Information

NPI Number : 1124975289
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONATHAN MICHAEL DIAZ M.A
Provider Business Mailing Address
First Line : 1901 S 24TH AVE
Second Line :
City : EDINBURG
State : TX
Zip : 78539-6533
Country : US
Telephone Number : 956-289-7000
Fax Number : 956-289-7257
Provider Business Practice Location Address
First Line : 1901 S 24TH AVE
Second Line :
City : EDINBURG
State : TX
Zip : 78539-6533
Country : US
Telephone Number : 956-289-7000
Fax Number : 956-289-7257
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2026
Last Update Date : 03/16/2026

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