Healthcare Provider Details

I. General information

NPI: 1629005418
Provider Name (Legal Business Name): RICHARD ARROYO-DIAZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1016 N VIRGINIA ST
PORT LAVACA TX
77979-3000
US

IV. Provider business mailing address

1200 N VIRGINIA ST
PORT LAVACA TX
77979-2507
US

V. Phone/Fax

Practice location:
  • Phone: 361-552-0325
  • Fax: 361-552-8759
Mailing address:
  • Phone: 361-552-6721
  • Fax: 361-552-7463

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberJ3731
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: