MEDICARE: MS. TAMMY RANE' DELAGARZA FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	728524	TX
2	363LP0200X	Pediatric Nurse Practitioner	AP123301	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356784276
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TAMMY RANE' DELAGARZA FNP-C

Provider Business Mailing Address
First Line	:	14960 PARK ROW DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77084-5165
Country	:	US
Telephone Number	:	281-298-1144
Fax Number	:	281-297-1133

Provider Business Practice Location Address
First Line	:	17520 W GRAND PKWY S STE 120
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-4759
Country	:	US
Telephone Number	:	281-298-1144
Fax Number	:	281-298-1133

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/10/2013
Last Update Date	:	08/30/2022

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