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NPI Code Detail

MEDICARE: ALAN DIAZ CSA

MEDICARE: ALAN DIAZ CSA
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
1363AS0400XSurgical Physician Assistant

General Provider Information

NPI Number : 1144506809
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALAN DIAZ CSA
Provider Business Mailing Address
First Line : 3404 RIDGE SMOKE
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78247-3458
Country : US
Telephone Number : 210-557-1281
Fax Number :
Provider Business Practice Location Address
First Line : 3404 RIDGE SMOKE
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78247-3458
Country : US
Telephone Number : 210-557-1281
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2011
Last Update Date : 01/23/2024

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Directions to “ ALAN DIAZ CSA” Practice Location

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