Healthcare Provider Details

I. General information

NPI: 1366575755
Provider Name (Legal Business Name): ALMA P DEL ANGEL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 06/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2909 N IH 35
AUSTIN TX
78722-2304
US

IV. Provider business mailing address

2909 N IH 35
AUSTIN TX
78755-2304
US

V. Phone/Fax

Practice location:
  • Phone: 512-478-4939
  • Fax: 512-320-0702
Mailing address:
  • Phone: 512-478-4939
  • Fax: 512-320-0702

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA49901
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberM8626
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: