Provider Demographics
NPI:1720245988
Name:DELGADO, NORMA ANGELICA
Entity Type:Individual
Prefix:MS
First Name:NORMA
Middle Name:ANGELICA
Last Name:DELGADO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 N CONWAY AVE
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-4102
Mailing Address - Country:US
Mailing Address - Phone:956-583-3330
Mailing Address - Fax:956-519-2884
Practice Address - Street 1:1020 N CONWAY AVE
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-4102
Practice Address - Country:US
Practice Address - Phone:956-583-3330
Practice Address - Fax:956-519-2884
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-16
Last Update Date:2019-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1073713442Medicaid