Provider Demographics
NPI:1013221274
Name:DIAZ RODRIGUEZ, HECTOR JAVIER (MD)
Entity Type:Individual
Prefix:DR
First Name:HECTOR
Middle Name:JAVIER
Last Name:DIAZ RODRIGUEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:HECTOR
Other - Middle Name:
Other - Last Name:DIAZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:7142 SAN PEDRO AVE STE 120
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-6256
Mailing Address - Country:US
Mailing Address - Phone:210-661-5622
Mailing Address - Fax:
Practice Address - Street 1:18707 HARDY OAK BLVD STE 530
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4791
Practice Address - Country:US
Practice Address - Phone:210-495-8280
Practice Address - Fax:210-481-3116
Is Sole Proprietor?:No
Enumeration Date:2010-07-29
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ8872207RN0300X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX361005702Medicaid