Provider Demographics
NPI:1497917595
Name:GABRIEL DIAZ MD PA
Entity Type:Organization
Organization Name:GABRIEL DIAZ MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:FLEMING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-664-0002
Mailing Address - Street 1:316 LINDBERG AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-2943
Mailing Address - Country:US
Mailing Address - Phone:956-664-0002
Mailing Address - Fax:956-664-2924
Practice Address - Street 1:316 LINDBERG AVE
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-2943
Practice Address - Country:US
Practice Address - Phone:956-664-0002
Practice Address - Fax:956-664-2924
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-30
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX200732001Medicaid
TX0001TMOtherBCBS
TXDP4829OtherRAILROAD MEDICARE
TXG43707Medicare UPIN
TX0001TMOtherBCBS