MEDICARE: MARTHA LETICIA DELGADO

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	171W00000X	Contractor	118594	TX

General Provider Information

NPI Number	:	1457578981
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARTHA LETICIA DELGADO

Provider Business Mailing Address
First Line	:	8508 FORTUNE CT
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79907-4922
Country	:	US
Telephone Number	:	915-858-8038
Fax Number	:

Provider Business Practice Location Address
First Line	:	8508 FORTUNE CT
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79907-4922
Country	:	US
Telephone Number	:	915-858-8038
Fax Number	:

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

Provider Enumeration Date	:	04/19/2007
Last Update Date	:	07/08/2007

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Directions to “ MARTHA LETICIA DELGADO ” Practice Location

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