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General NPI Number Information
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NPI Number | 1538679741
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Entity Type | Individual
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Provider Name | MATTHEW KRISTOPHER DELGADO DC
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Gender | Male
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Dates
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Enumeration Date | 10/03/2017
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Last Update Date | 07/13/2019
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Provider Practice Location Address
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Address Line | 2612 S LAMAR BLVD # A
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City | AUSTIN
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State | TX
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Zip | 78704-4733
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Country | US
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Telephone | 512-400-1241
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Fax |
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Provider Business Mailing Address
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Address Line | 2612 S LAMAR BLVD # A
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City | AUSTIN
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State | TX
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Zip | 78704-4733
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Country | US
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Telephone | 512-400-1241
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 13582
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License Number State | TX
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