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1851158075 NPI number — KRYSTAL LYNN DELGADO , PT, DT, MAT

NPI Number: 1851158075
Health Care Provider/Practitioner: KRYSTAL LYNN DELGADO , PT, DT, MAT

Information about “1851158075” NPI (KRYSTAL LYNN DELGADO , PT, DT, MAT) exists in 1851158075 in HTML format HTML  |  1851158075 in plain Text format TXT  |  1851158075 in PDF (Portable Document Format) PDF  |  1851158075 in an XML format XML  formats.

NPI Number : 1851158075 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1851158075",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "DELGADO",
    "FirstName": "KRYSTAL",
    "MiddleName": "LYNN",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": ", PT, DT, MAT",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "407 AVENUE E",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ABERNATHY",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "79311-3322",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "806-778-0975",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "320 N MAIN STREET",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LOCKNEY",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "79241",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "806-652-3373",
    "PracticeLocationAddressFaxNumber": "806-652-2836",
    "EnumerationDate": "03/04/2024",
    "LastUpdateDate": "03/04/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "225100000X",
        "TaxonomyName": "Physical Therapist",
        "LicenseNumber": "1150481",
        "LicenseNumberStateCode": "TX",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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