Provider Demographics
NPI:1316956600
Name:NORMA L. DELACRUZ, PC
Entity type:Organization
Organization Name:NORMA L. DELACRUZ, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMININSTRATOR / OTR
Authorized Official - Prefix:MR
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:DELACRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:956-969-9532
Mailing Address - Street 1:1010 S AIRPORT DR STE B
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-6650
Mailing Address - Country:US
Mailing Address - Phone:956-969-9532
Mailing Address - Fax:956-969-9562
Practice Address - Street 1:1010 S AIRPORT DR STE B
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-6650
Practice Address - Country:US
Practice Address - Phone:956-969-9532
Practice Address - Fax:956-969-9562
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX163549201Medicaid
TX454841Medicare PIN