Provider Demographics
NPI:1457775439
Name:DELA CRUZ, LARRY ROBERTO (CERTIFIED SURGICAL F)
Entity Type:Individual
Prefix:MR
First Name:LARRY
Middle Name:ROBERTO
Last Name:DELA CRUZ
Suffix:
Gender:M
Credentials:CERTIFIED SURGICAL F
Other - Prefix:
Other - First Name:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:218 MACKEY DRIVE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78213
Mailing Address - Country:US
Mailing Address - Phone:210-218-2902
Mailing Address - Fax:210-236-9621
Practice Address - Street 1:218 MACKEY DRIVE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78213
Practice Address - Country:US
Practice Address - Phone:210-218-2902
Practice Address - Fax:210-236-9621
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-11
Last Update Date:2014-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant