Provider Demographics
NPI:1528020914
Name:DIAZ-LABOY, CARLOS ALBERTO (DMD)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:ALBERTO
Last Name:DIAZ-LABOY
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 1:9301 OLD BEE CAVES RD APT 127
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78735-8276
Mailing Address - Country:US
Mailing Address - Phone:512-921-1183
Mailing Address - Fax:
Practice Address - Street 1:1144 AIRPORT BLVD STE 240
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78702-3165
Practice Address - Country:US
Practice Address - Phone:512-666-2466
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0496531223G0001X
PADS0354741223G0001X
PR20241223G0001X
TX277821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice