Provider Demographics
NPI:1396303434
Name:DELAGARZA, REBECCA D
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:D
Last Name:DELAGARZA
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 1:921 CAMPBELL ST
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-2413
Mailing Address - Country:US
Mailing Address - Phone:361-510-8403
Mailing Address - Fax:
Practice Address - Street 1:921 CAMPBELL ST
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-2413
Practice Address - Country:US
Practice Address - Phone:361-510-8403
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-04
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator