Individual
JUAN CARLOS DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3152 BLUE DIRT CIR, EL PASO, TX 79938-2506
(915) 922-0313
Mailing address
3152 BLUE DIRT CIR, EL PASO, TX 79938-2506
(915) 922-0313
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
LHOC23-00038
TX
Other
Enumeration date
05/30/2023
Last updated
05/30/2023
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