Individual
JESUS ESTEBAN DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LVN
Contact information
Practice address
2102 W TEEGE AVE, HARLINGEN, TX 78550-4667
(956) 412-3337
Mailing address
1401 RIO BLANCO ST, SAN JUAN, TX 78589-5127
(956) 533-5201
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
200848
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790847531
—
TX
Enumeration date
07/25/2018
Last updated
04/03/2020
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