Provider Demographics
NPI:1194856245
Name:DELIGANS, PAT ROSSO (PT)
Entity Type:Individual
Prefix:MRS
First Name:PAT
Middle Name:ROSSO
Last Name:DELIGANS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2004
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75091-2004
Mailing Address - Country:US
Mailing Address - Phone:903-892-9590
Mailing Address - Fax:903-893-4449
Practice Address - Street 1:3409 POST OAK XING
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75092-3492
Practice Address - Country:US
Practice Address - Phone:903-892-9590
Practice Address - Fax:903-893-4449
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2016-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1017721225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4427186OtherAETNA US HEALTHCARE PIN
TX80246TOtherBLUE CROSS BLUE SHIELD #
TXP00308571Medicare PIN
TXR69364Medicare UPIN
TX650229Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER