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General NPI Number Information
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NPI Number | 1558391730
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Entity Type | Organization
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Legal Business Name | DEL RIO TEXAS HEART INSTITUTE & DIABETES CENTER PA
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Dates
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Enumeration Date | 07/04/2006
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Last Update Date | 12/07/2009
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Provider Practice Location Address
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Address Line | 3809 VETERANS BLVD
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City | DEL RIO
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State | TX
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Zip | 78840-2860
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Country | US
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Telephone | 830-703-8555
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Fax | 830-703-8334
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Provider Business Mailing Address
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Address Line | 3809 VETERANS BLVD
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City | DEL RIO
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State | TX
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Zip | 78840-2860
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Country | US
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Telephone | 830-703-8555
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Fax | 830-703-8334
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHELE DI BLASI
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Credential | M.D.
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Telephone | 830-703-8555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | L7944
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | L7952
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License Number State | TX
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