Diaz Wong, Roque Alberto

Diaz Wong, Roque Alberto is an individual health care provider with primary practice located at 4330 Medical Dr Ste 105 , San Antonio TX 78229-3342. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Nephrology. Allopathic & Osteopathic Physicians / Nephrology is his primary health care specialty. Diaz Wong, Roque Alberto can be contacted via phone (210) 692-7228.

Contact Information

Primary practice address
4330 Medical Dr Ste 105 San Antonio TX 78229-3342
Fax: (210) 692-9671
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 4301089787 Michigan
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X P5965 Texas

Profile Details

NPI number 1477758357
LBN Legal business name Diaz Wong, Roque Alberto
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 19th, 2007
Last updated Aug 26th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477758357 NPPES
Texas MEDICAID 324927801

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