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NPI Code Detail

MEDICARE: DR. ROBERTO BAYLON DELA CRUZ JR. MD

MEDICARE: DR. ROBERTO BAYLON DELA CRUZ JR. MD
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
1207Q00000XFamily Medicine PhysicianN1303TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1912101577
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROBERTO BAYLON DELA CRUZ JR. MD
Provider Business Mailing Address
First Line : 1410 E RENNER RD STE 201
Second Line :
City : RICHARDSON
State : TX
Zip : 75082-2227
Country : US
Telephone Number : 972-234-3311
Fax Number :
Provider Business Practice Location Address
First Line : 1410 E RENNER RD STE 201
Second Line :
City : RICHARDSON
State : TX
Zip : 75082-2227
Country : US
Telephone Number : 972-234-3311
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2007
Last Update Date : 05/29/2024

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Directions to “ DR. ROBERTO BAYLON DELA CRUZ JR. MD” Practice Location

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