Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 28347 | TX |
NPI | 1114277407 |
---|---|
Provider Name | Dr. Marianna Delgado |
First Address | Houston, TX 77040 |
Second Address | Houston, TX 77040 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2012 |
Last Update Date | 13/09/2012 |