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General NPI Number Information
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NPI Number | 1417984840
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Entity Type | Individual
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Provider Name | MICHAEL DEAN DELLIS OD
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Gender | Male
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Dates
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Enumeration Date | 06/28/2006
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Last Update Date | 06/21/2012
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Provider Practice Location Address
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Address Line | 1400 EAST FRANKLIN STREET
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City | HILLSBORO
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State | TX
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Zip | 76645-0779
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Country | US
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Telephone | 254-582-2351
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Fax | 254-582-7017
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Provider Business Mailing Address
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Address Line | PO BOX 779
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City | HILLSBORO
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State | TX
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Zip | 76645-0779
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Country | US
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Telephone | 254-582-2351
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Fax | 254-582-7017
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2348TG
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License Number State | TX
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