Provider Demographics
NPI:1417964255
Name:QUISENBERRY, DELIA M (MD)
Entity type:Individual
Prefix:DR
First Name:DELIA
Middle Name:M
Last Name:QUISENBERRY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 2ND ST
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78404-2303
Mailing Address - Country:US
Mailing Address - Phone:361-442-0138
Mailing Address - Fax:361-884-2919
Practice Address - Street 1:1001 2ND ST
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78404-2303
Practice Address - Country:US
Practice Address - Phone:361-442-0138
Practice Address - Fax:361-884-2919
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL8905207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX171982502Medicaid
TX00X193Medicare PIN
TXTXB115388Medicare PIN
TX171982502Medicaid