Individual
AL DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1072 E LOS EBANOS BLVD, BROWNSVILLE, TX 78520-9988
(956) 541-1278
(956) 541-2854
Mailing address
4100 INTERNATIONAL PLAZA, SUITE 600, FORT WORTH, TX 76109
(817) 334-0530
(817) 877-0350
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
698565
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
130752
SUPERIOR
TX
05
—
166014402
—
TX
Enumeration date
06/16/2006
Last updated
10/30/2013
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