Provider Demographics
NPI:1083325401
Name:DELGADO, ANDRES (RD)
Entity type:Individual
Prefix:
First Name:ANDRES
Middle Name:
Last Name:DELGADO
Suffix:
Gender:M
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12220 RC POE RD STE A
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79938-4921
Mailing Address - Country:US
Mailing Address - Phone:915-642-9444
Mailing Address - Fax:915-800-8570
Practice Address - Street 1:12220 RC POE RD STE A
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79938-4921
Practice Address - Country:US
Practice Address - Phone:915-642-9444
Practice Address - Fax:915-800-8570
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-06
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT88083133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered