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General NPI Number Information
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NPI Number | 1942484670
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Entity Type | Individual
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Provider Name | ANIBAL ROBERTO DIOGENES DDS, PHD
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Gender | Male
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Dates
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Enumeration Date | 12/17/2007
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Last Update Date | 11/15/2016
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Provider Practice Location Address
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Address Line | 8210 FLOYD CURL DR DEPARTMENT OF ENDODONTICS
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City | SAN ANTONIO
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State | TX
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Zip | 78229-3923
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Country | US
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Telephone | 210-450-3611
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Fax |
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Provider Business Mailing Address
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Address Line | 8210 FLOYD CURL DRIVE DEPARTMENT OF ENDODONTICS
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City | SAN ANTONIO
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State | TX
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Zip | 78229
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Country | US
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Telephone | 210-450-3611
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | UTSA 815-X
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License Number State | TX
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