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General NPI Number Information
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NPI Number | 1053570952
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Entity Type | Organization
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Legal Business Name | ROBERT DELUCA, D.O,, P.A.
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Dates
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Enumeration Date | 06/05/2008
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Last Update Date | 05/15/2015
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Provider Practice Location Address
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Address Line | 500 W PLUMMER ST
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City | EASTLAND
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State | TX
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Zip | 76448-2629
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Country | US
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Telephone | 254-629-3393
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Fax | 254-629-3392
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Provider Business Mailing Address
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Address Line | 500 W PLUMMER ST
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City | EASTLAND
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State | TX
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Zip | 76448-2629
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Country | US
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Telephone | 254-629-3393
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Fax | 254-629-3392
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | SHELLYE TRURAN
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Credential |
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Telephone | 254-629-3393
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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