Healthcare Provider Details

I. General information

NPI: 1225591829
Provider Name (Legal Business Name): YEZIKA DELGADO MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2019
Last Update Date: 08/27/2020
Certification Date: 08/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2270 JOE BATTLE BLVD STE E-G
EL PASO TX
79938-2609
US

IV. Provider business mailing address

2270 JOE BATTLE BLVD STE E-G
EL PASO TX
79938-2609
US

V. Phone/Fax

Practice location:
  • Phone: 915-642-9444
  • Fax: 915-800-8570
Mailing address:
  • Phone: 915-642-9444
  • Fax: 915-800-8570

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: YEZIKA ANITZA DELGADO
Title or Position: OWNER
Credential: MD PA
Phone: 915-642-9444