Provider Demographics
NPI:1962628255
Name:DELACRUZ, RICARDO (OCCUPATIONAL THERAPI)
Entity Type:Individual
Prefix:MR
First Name:RICARDO
Middle Name:
Last Name:DELACRUZ
Suffix:
Gender:M
Credentials:OCCUPATIONAL THERAPI
Other - Prefix:MR
Other - First Name:RICARDO
Other - Middle Name:
Other - Last Name:DELACRUZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OCCUPATIONAL THERAPI
Mailing Address - Street 1:1010 S AIRPORT DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-6600
Mailing Address - Country:US
Mailing Address - Phone:956-969-9532
Mailing Address - Fax:956-969-9562
Practice Address - Street 1:1010 S AIRPORT DR
Practice Address - Street 2:SUITE B
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-6600
Practice Address - Country:US
Practice Address - Phone:956-969-9532
Practice Address - Fax:956-969-9562
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX107814225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist