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Individual

DR. CHRISTOPHER DAVID DIAZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
800 E DAWSON ST, TYLER, TX 75701-2036
(903) 593-8441
Mailing address
PO BOX 841656, DALLAS, TX 75284-1656
(903) 531-5000

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
N9692
TX
208D00000X
General Practice Physician
35.085504
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
283196801
TX
05
283196802
TX
05
283196803
TX
05
283196809
TX
01
75-0818167-044
TRICARE
TX
01
75-0818167-048
TRICARE
TX
01
75-2616977-001
TRICARE
TX
01
75-2616977-002
TRICARE
TX
01
75-2616977-028
TRICARE
TX
01
750818167022
TRICARE
TX
01
8CV290
BCBS
TX
01
8CV291
BCBS
TX
01
8DQ153
BCBS
TX
01
8EZ069
BCBS
TX
01
P00966738
RAIL ROAD
TX
01
P01464105
RAIL ROAD MEDICARE
TX
Enumeration date
10/06/2005
Last updated
07/10/2015
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