Organization
ANTONIO M. DIAZ JR MDPA INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS ERICKA PARRA (OFFICE MANAGER)
(956) 541-5231
Entity
Organization
Contact information
Practice address
864 CENTRAL BLVD., STE. #100, BROWNSVILLE, TX 78520-7551
(956) 541-5231
(956) 541-3230
Mailing address
P.O. BOX 4119, BROWNSVILLE, TX 78523-4119
(956) 541-5231
(956) 541-3230
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E5508
TX
305R00000X
Preferred Provider Organization
E5508
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1160400-01
—
TX
05
—
116040001
—
TX
Enumeration date
01/18/2007
Last updated
03/02/2012
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