Individual
GREGORY C. DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3560 DELAWARE ST, 209, BEAUMONT, TX 77706-3059
(409) 899-3682
Mailing address
3560 DELAWARE ST, 209, BEAUMONT, TX 77706-3059
(409) 899-3682
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
L0130
TX
2085R0202X
Diagnostic Radiology Physician
Primary
L0130
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
043862401
—
TX
Enumeration date
06/13/2005
Last updated
03/01/2024
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