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General NPI Number Information
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NPI Number | 1639484355
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Entity Type | Individual
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Provider Name | RAMONA DELMUNDO-BACANI FNP
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Gender | Female
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Dates
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Enumeration Date | 08/18/2010
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Last Update Date | 10/31/2016
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Provider Practice Location Address
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Address Line | 4811A COLUMBIA AVE
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City | DALLAS
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State | TX
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Zip | 75226-1034
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Country | US
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Telephone | 214-823-5590
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Fax | 214-823-6638
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Provider Business Mailing Address
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Address Line | 608 W DAVIS ST STE 101
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City | MESQUITE
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State | TX
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Zip | 75149-4108
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Country | US
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Telephone | 972-289-2273
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Fax | 972-285-1396
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 457401
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License Number State | TX
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