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NPI Code Detail

MEDICARE: DIEGO BARBARA MIJARES M.D.

MEDICARE: DIEGO BARBARA MIJARES M.D.
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
1207V00000XObstetrics & Gynecology PhysicianT7491TX
2207V00000XObstetrics & Gynecology Physician25MA10355800NJ

General Provider Information

NPI Number : 1134522634
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIEGO BARBARA MIJARES M.D.
Provider Business Mailing Address
First Line : PO BOX 844658
Second Line :
City : DALLAS
State : TX
Zip : 75284-4658
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 200 MEDICAL PKWY STE 310
Second Line :
City : LAKEWAY
State : TX
Zip : 78738-1794
Country : US
Telephone Number : 512-654-1234
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2014
Last Update Date : 09/08/2022

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