Healthcare Provider Details

I. General information

NPI: 1013008721
Provider Name (Legal Business Name): ROBERT LOUIS DELILLO DNP, CRNA, NSPM-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 08/01/2025
Certification Date: 08/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1805 KINSALE DR
KELLER TX
76262-9023
US

IV. Provider business mailing address

1805 KINSALE DR
KELLER TX
76262-9023
US

V. Phone/Fax

Practice location:
  • Phone: 817-966-2762
  • Fax:
Mailing address:
  • Phone: 817-966-2762
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number514647
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: