Basic Information
| Provider Information | |||||||||
| NPI: | 1073040614 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DIAZ VOSS VARELA | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | ANTOLIN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1155 MILL ST | ||||||||
| Address2: | MS M14 | ||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 895021576 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7759825262 | ||||||||
| FaxNumber: | 7759825496 | ||||||||
| Practice Location | |||||||||
| Address1: | 2102 TREASURE HILLS BLVD | ||||||||
| Address2: | |||||||||
| City: | HARLINGEN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785508736 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9562961590 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/14/2017 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/21/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | 20177 | NV | N | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | 20177 | NV | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.