Basic Information
Provider Information
NPI: 1245649037
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DELGADO RAMOS
FirstName: FABRIZZIO
MiddleName: ANDRES
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 845347
Address2:  
City: DALLAS
State: TX
PostalCode: 752845347
CountryCode: US
TelephoneNumber: 2146450624
FaxNumber: 2146450078
Practice Location
Address1: 5200 HARRY HINES BLVD
Address2:  
City: DALLAS
State: TX
PostalCode: 752357709
CountryCode: US
TelephoneNumber: 4694199606
FaxNumber: 2142671632
Other Information
ProviderEnumerationDate: 08/06/2014
LastUpdateDate: 07/22/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/22/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0802XR5997TXN Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
2084P0800XR5997TXY193400000X MULTIPLE SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


Home