Individual
DR. DIEGO JOSE MASELLI CACERES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4502 MEDICAL DR, SAN ANTONIO, TX 78229-4402
(210) 358-2015
Mailing address
7703 FLOYD CURL DR, SAN ANTONIO, TX 78229-3901
(210) 617-5300
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
P2730
TX
207RP1001X
Pulmonary Disease Physician
Primary
P2730
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
296013001
—
TX
01
—
296013002
MEDICAID (CSHCN)
TX
Enumeration date
05/07/2009
Last updated
07/26/2012
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