Provider Demographics
NPI:1992396220
Name:DELASALAS MEDICAL CONSULTING LLC
Entity Type:Organization
Organization Name:DELASALAS MEDICAL CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:
Authorized Official - Last Name:DELASALAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-484-8338
Mailing Address - Street 1:2728 MCKINNON ST APT 921
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75201-1640
Mailing Address - Country:US
Mailing Address - Phone:314-484-8338
Mailing Address - Fax:
Practice Address - Street 1:2728 MCKINNON ST APT 921
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75201-1640
Practice Address - Country:US
Practice Address - Phone:314-484-8338
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-29
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty