Individual
JUAN DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCDC
Contact information
Practice address
601 N FRIO ST BLDG 2, SAN ANTONIO, TX 78207-3011
(210) 261-3001
(210) 731-9661
Mailing address
6800 PARK TEN BLVD STE 200S, SAN ANTONIO, TX 78213-4293
(210) 261-1060
(210) 261-1821
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
14713
TX
Other
Enumeration date
10/26/2022
Last updated
10/26/2022
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