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ASHLEY BRANDON DELACERDA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
220 E. HARRIS, SAN ANGELO, TX 76903
(325) 481-2215
(325) 481-2180
Mailing address
PO BOX 22000, SAN ANGELO, TX 76902-7200
(325) 658-1511
(325) 481-2166

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
Q2892
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
346821701
TX
01
418771YKRY
MEDICARE PTAN
TX
01
8FB936
BCBS
TX
Enumeration date
05/23/2011
Last updated
12/26/2017
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