Healthcare Provider Details

I. General information

NPI: 1861757775
Provider Name (Legal Business Name): ARMANDO DELAGARZA NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2012
Last Update Date: 07/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5920 SARATOGA BLVD SUITE 475
CORPUS CHRISTI TX
78414-4119
US

IV. Provider business mailing address

5920 SARATOGA BLVD SUITE 475
CORPUS CHRISTI TX
78414-4119
US

V. Phone/Fax

Practice location:
  • Phone: 361-654-2064
  • Fax:
Mailing address:
  • Phone: 361-654-2064
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number12609
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: