Healthcare Provider Details

I. General information

NPI: 1760296701
Provider Name (Legal Business Name): MIGUEL DIAZ RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/01/2025
Last Update Date: 10/02/2025
Certification Date: 10/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 E HOUSTON ST
BEEVILLE TX
78102-5259
US

IV. Provider business mailing address

7807 SARATOGA KNL
SCHERTZ TX
78154-3898
US

V. Phone/Fax

Practice location:
  • Phone: 361-542-6247
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1000674
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code163WR0400X
TaxonomyRehabilitation Registered Nurse
License Number1000674
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: