Provider Demographics
NPI:1851158075
Name:DELGADO, KRYSTAL LYNN (, PT, DT, MAT)
Entity Type:Individual
Prefix:
First Name:KRYSTAL
Middle Name:LYNN
Last Name:DELGADO
Suffix:
Gender:F
Credentials:, PT, DT, MAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 AVENUE E
Mailing Address - Street 2:
Mailing Address - City:ABERNATHY
Mailing Address - State:TX
Mailing Address - Zip Code:79311-3322
Mailing Address - Country:US
Mailing Address - Phone:806-778-0975
Mailing Address - Fax:
Practice Address - Street 1:320 N MAIN STREET
Practice Address - Street 2:
Practice Address - City:LOCKNEY
Practice Address - State:TX
Practice Address - Zip Code:79241
Practice Address - Country:US
Practice Address - Phone:806-652-3373
Practice Address - Fax:806-652-2836
Is Sole Proprietor?:No
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1150481225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist