Organization
DELAR PEDIATRICS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEENI LUZ DE LA ROSA PEREZ MD (MEDICAL DIRECTOR)
(817) 513-5155
Entity
Organization
Contact information
Practice address
1430 N MACARTHUR BLVD STE 107, IRVING, TX 75061-4480
(817) 513-5155
(888) 502-0861
Mailing address
2 MANCHESTER CT, MANSFIELD, TX 76063-7613
(202) 903-1319
(888) 502-0861
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
208000000X
Pediatrics Physician
Primary
—
—
261QH0100X
Health Service Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3409815
—
TX
Enumeration date
06/23/2022
Last updated
02/17/2023
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