Individual
GONZALO A DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4305 N MESA ST STE B, EL PASO, TX 79902-1124
(915) 779-7378
(915) 779-2822
Mailing address
4305 N MESA ST STE B, EL PASO, TX 79902-1124
(915) 779-7378
(915) 779-2822
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
G4109
TX
207RS0012X
Sleep Medicine (Internal Medicine) Physician
G4109
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000U9973
—
NM
05
—
138134508
—
TX
Enumeration date
07/29/2005
Last updated
01/30/2025
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