Healthcare Provider Details

I. General information

NPI: 1245649037
Provider Name (Legal Business Name): FABRIZZIO ANDRES DELGADO RAMOS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2014
Last Update Date: 07/22/2022
Certification Date: 07/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5200 HARRY HINES BLVD
DALLAS TX
75235-7709
US

IV. Provider business mailing address

PO BOX 845347
DALLAS TX
75284-5347
US

V. Phone/Fax

Practice location:
  • Phone: 469-419-9606
  • Fax: 214-267-1632
Mailing address:
  • Phone: 214-645-0624
  • Fax: 214-645-0078

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License NumberR5997
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberR5997
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: