Provider Demographics
NPI:1093131161
Name:DIAZ ARANA, JOEL ENRIQUE (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:ENRIQUE
Last Name:DIAZ ARANA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8706 FREDERICKSBURG RD STE 105
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-1293
Mailing Address - Country:US
Mailing Address - Phone:210-774-4241
Mailing Address - Fax:210-774-6995
Practice Address - Street 1:8706 FREDERICKSBURG RD STE 105
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1293
Practice Address - Country:US
Practice Address - Phone:917-862-0342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-12
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31371122300000X, 1223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
No122300000XDental ProvidersDentist