Individual provider Active NPI

Josefina Delgado, O.D.

  • Optometrist
  • Fort Worth, TX
National Provider Identifier
1093740896
Registry record updated Aug 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
04964T Issued in TX
Practice address
7108 Camp Bowie Blvd
Fort Worth, TX 76116-7121
Phone
(817) 738-3191
Fax
(817) 738-7724
NPI assigned
Jul 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 04964T TX Primary

Addresses

Primary practice location

7108 Camp Bowie Blvd
Fort Worth, TX 76116-7121

Mailing address

7108 Camp Bowie Blvd
Fort Worth, TX 76116-7121
Phone (817) 738-3191

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
04964TTXMDOptometrist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407888000000",
    "number": "1093740896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7108 CAMP BOWIE BLVD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761167121",
            "telephone_number": "817-738-3191",
            "fax_number": "817-738-7724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7108 CAMP BOWIE BLVD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761167121",
            "telephone_number": "817-738-3191",
            "fax_number": "817-738-7724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELGADO",
        "first_name": "JOSEFINA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2014-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "04964T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.