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General NPI Number Information
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NPI Number | 1053044818
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Entity Type | Individual
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Provider Name | NICOLE SOFIA DELGADO PA
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Gender | Female
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Dates
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Enumeration Date | 07/07/2022
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Last Update Date | 03/05/2024
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Provider Practice Location Address
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Address Line | 7011 RIBELIN RANCH RD STE 200
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City | AUSTIN
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State | TX
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Zip | 78750-8585
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Country | US
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Telephone | 512-345-7436
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Fax |
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Provider Business Mailing Address
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Address Line | 7122 WOOD HOLLOW DR APT 35
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City | AUSTIN
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State | TX
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Zip | 78731-2545
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Country | US
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Telephone | 210-548-1165
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA17513
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License Number State | TX
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