Active NPI
Abraham Heriberto Diaz III, LCDC
- Addiction (Substance Use Disorder) Counselor
- Laredo, TX
National Provider Identifier
1982447876
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 16698
- Practice address
- 4502 Mims Ave
Laredo, TX 78041-3552 - Phone
- (956) 229-0780
- NPI assigned
- Jun 17, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 16698 | TX | Primary |
Addresses
Primary practice location
4502 Mims Ave
Laredo, TX 78041-3552
Mailing address
4502 Mims Ave
Laredo, TX 78041-3552
Phone (956) 229-0780
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16698 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1718582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718582400000",
"number": "1982447876",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4502 MIMS AVE",
"city": "LAREDO",
"state": "TX",
"postal_code": "780413552",
"telephone_number": "956-229-0780"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4502 MIMS AVE",
"city": "LAREDO",
"state": "TX",
"postal_code": "780413552",
"telephone_number": "956-229-0780"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIAZ",
"first_name": "ABRAHAM",
"middle_name": "HERIBERTO",
"name_prefix": "Mr.",
"name_suffix": "III",
"credential": "LCDC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-06-17",
"last_updated": "2024-06-17",
"certification_date": "2024-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "TX",
"license": "16698",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Laredo, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.