Provider Demographics
NPI:1639484355
Name:DELMUNDO-BACANI, RAMONA (FNP)
Entity Type:Individual
Prefix:
First Name:RAMONA
Middle Name:
Last Name:DELMUNDO-BACANI
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:RAMONA
Other - Middle Name:M
Other - Last Name:BACANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:608 W DAVIS ST
Mailing Address - Street 2:STE 101
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75149-4108
Mailing Address - Country:US
Mailing Address - Phone:972-289-2273
Mailing Address - Fax:972-285-1396
Practice Address - Street 1:4811A COLUMBIA AVE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75226-1034
Practice Address - Country:US
Practice Address - Phone:214-823-5590
Practice Address - Fax:214-823-6638
Is Sole Proprietor?:No
Enumeration Date:2010-08-18
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX457401363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily