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NPI 1629497482

NPI 1629497482 : MR. DELFINO ESTEVAN LORENZO : AUSTIN, TX

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General NPI Number Information
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    NPI Number           |    1629497482
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    Entity Type          |    Individual 
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    Provider Name        |    MR. DELFINO ESTEVAN LORENZO
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    04/09/2014
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    Last Update Date     |    09/20/2019
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Provider Practice Location Address
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    Address Line         |    3816 S 1ST ST 
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    City                 |    AUSTIN
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    State                |    TX
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    Zip                  |    78704
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    Country              |    US
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    Telephone            |    512-443-1311
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    Fax                  |    512-406-6266
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Provider Business Mailing Address
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    Address Line         |    6210 E US HWY 290 STE. 420 - CREDENTIALING
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    City                 |    AUSTIN
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    State                |    TX
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    Zip                  |    78723-1098
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    Country              |    US
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    Telephone            |    512-338-3826
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    Fax                  |    512-406-6216
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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        |    208600000X
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    Taxonomy Name        |    Surgery Physician
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    License Number       |    S0500
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    License Number State |    TX
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