Individual
REBECCA DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1220 N MALINCHE AVE, LAREDO, TX 78043-3354
(956) 722-2431
(956) 722-7553
Mailing address
PO BOX 1620, LAREDO, TX 78044-1620
(956) 722-2431
(956) 722-7553
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
39688
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
39688
LICENSE
TX
Enumeration date
06/06/2008
Last updated
05/11/2011
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