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Individual

MINI DELASHAW

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
12221 MERIT DR, SUITE 1610, DALLAS, TX 75251-2202
(832) 498-6356
Mailing address
12221 MERIT DR, SUITE 1610, DALLAS, TX 75251-2202
(832) 498-6356

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
M3515
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
182217301
TX
05
182217302
TX
01
8V2879
BCBS
TX
01
P00364139
RAILROAD
TX
Enumeration date
06/14/2006
Last updated
06/29/2011
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