Provider Demographics
NPI:1215652508
Name:DEL RIO, ISAAC (PHD)
Entity type:Individual
Prefix:DR
First Name:ISAAC
Middle Name:
Last Name:DEL RIO
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 W OVERLAND AVE STE 250H
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79901-1090
Mailing Address - Country:US
Mailing Address - Phone:915-233-7145
Mailing Address - Fax:
Practice Address - Street 1:500 W OVERLAND AVE STE 250H
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79901-1090
Practice Address - Country:US
Practice Address - Phone:915-233-7145
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-10
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39581103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling