Provider Demographics
NPI:1639267602
Name:DELLEFAVE, LOUIS ANTHONY (RNFA)
Entity Type:Individual
Prefix:MR
First Name:LOUIS
Middle Name:ANTHONY
Last Name:DELLEFAVE
Suffix:
Gender:M
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 W 11TH ST
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:TX
Mailing Address - Zip Code:76574-2937
Mailing Address - Country:US
Mailing Address - Phone:512-973-9222
Mailing Address - Fax:
Practice Address - Street 1:120 W 11TH ST
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:TX
Practice Address - Zip Code:76574-2937
Practice Address - Country:US
Practice Address - Phone:512-973-9222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2014-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX504849163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant