{
"Npi": {
"NPI": "1013008721",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "DELILLO",
"FirstName": "ROBERT",
"MiddleName": "LOUIS",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "DNP, CRNA, NSPM-C",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1805 KINSALE DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "KELLER",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "76262-9023",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "817-966-2762",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1805 KINSALE DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "KELLER",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "76262-9023",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "817-966-2762",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "09/27/2006",
"LastUpdateDate": "08/01/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "367500000X",
"TaxonomyName": "Certified Registered Nurse Anesthetist",
"LicenseNumber": "514647",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}