Individual
DERRICK DELGADO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
5312 RIO BRAVO DR STE 7, SANTA TERESA, NM 88008-9210
(575) 201-3726
Mailing address
1229 COYOTE LN, EL PASO, TX 79912-7490
(915) 252-0596
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
PTA1723
NM
261QP2000X
Physical Therapy Clinic/Center
Primary
PTA1723
NM
Other
Enumeration date
07/21/2016
Last updated
10/19/2025
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