Provider Demographics
NPI:1194721480
Name:DIAZ, JOSE M (MD)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:M
Last Name:DIAZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:507 PARK GROVE DR
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-1759
Mailing Address - Country:US
Mailing Address - Phone:281-206-2127
Mailing Address - Fax:281-206-2127
Practice Address - Street 1:507 PARK GROVE DR
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-1759
Practice Address - Country:US
Practice Address - Phone:281-206-2127
Practice Address - Fax:812-206-2127
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2024-09-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXJ09422084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX153449704OtherMNA MDCD GRP TPI HARRIS CO
TX00106WOtherMNA GRP PTAN # HARRIS CO
TXD6392OtherMNA GRP RR MDCR PTAN