Basic Information
| Provider Information | |||||||||
| NPI: | 1639484355 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DELMUNDO-BACANI | ||||||||
| FirstName: | RAMONA | ||||||||
| MiddleName: | |||||||||
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| Credential: | FNP | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | BACANI | ||||||||
| OtherFirstName: | RAMONA | ||||||||
| OtherMiddleName: | M | ||||||||
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| OtherCredential: | RN | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 608 W DAVIS ST | ||||||||
| Address2: | STE 101 | ||||||||
| City: | MESQUITE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 751494108 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9722892273 | ||||||||
| FaxNumber: | 9722851396 | ||||||||
| Practice Location | |||||||||
| Address1: | 4811A COLUMBIA AVE | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752261034 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2148235590 | ||||||||
| FaxNumber: | 2148236638 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/18/2010 | ||||||||
| LastUpdateDate: | 10/31/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 457401 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.