MEDICARE: MR. ARMANDO DELAGARZA NP

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	12609	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	12609	OTHER	TX	LICENSE

General Provider Information

NPI Number	:	1861757775
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ARMANDO DELAGARZA NP

Provider Business Mailing Address
First Line	:	5920 SARATOGA BLVD
Second Line	:	SUITE 475
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78414-4119
Country	:	US
Telephone Number	:	361-654-2064
Fax Number	:

Provider Business Practice Location Address
First Line	:	5920 SARATOGA BLVD
Second Line	:	SUITE 475
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78414-4119
Country	:	US
Telephone Number	:	361-654-2064
Fax Number	:

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

Provider Enumeration Date	:	07/06/2012
Last Update Date	:	07/17/2012

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