Provider Demographics
NPI:1083997423
Name:DELGADO, MYRELSIE (PHARMACIST)
Entity Type:Individual
Prefix:DR
First Name:MYRELSIE
Middle Name:
Last Name:DELGADO
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2019 WINDING HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-5102
Mailing Address - Country:US
Mailing Address - Phone:832-721-7719
Mailing Address - Fax:
Practice Address - Street 1:20675 FM 1093 RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-7778
Practice Address - Country:US
Practice Address - Phone:281-239-7132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-22
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX45750183500000X
FLPS040813183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist