Individual
DIEGO BARBARA MIJARES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 MEDICAL PKWY STE 310, LAKEWAY, TX 78738-1794
(512) 654-1234
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
25MA10355800
NJ
207V00000X
Obstetrics & Gynecology Physician
Primary
T7491
TX
Other
Enumeration date
09/29/2014
Last updated
09/08/2022
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