Delius Lavern Roach Jr., PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA03478 Issued in TX

Practice address

5788 Eckhert Rd
San Antonio, TX 78240-3900

Phone

(210) 699-2127

Fax

(210) 699-2257

NPI assigned

Sep 20, 2006

Last updated

Jan 29, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264723200000",
    "number": "1861599946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5788 ECKHERT RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782403900",
            "telephone_number": "210-699-2127",
            "fax_number": "210-699-2257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5788 ECKHERT RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782403900",
            "telephone_number": "210-699-2127",
            "fax_number": "210-699-2257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROACH",
        "first_name": "DELIUS",
        "middle_name": "LAVERN",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2010-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA03478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• RN Plus Medical Supplies, Inc
• RN Plus Medical Supplies, Inc
• RN Plus Medical Supplies, Inc
• Barbara Lynn Roach, MD
• Cayce Joseph Roach, M.D.
• Derrell Jay Roach, DDS
• Robert Bryan Roach Jr., D.D.S.
• Catalina Roads, PSY.D.
• Terrell Roane
• Alissa Nicole Robbins, PA-C

• Physician Assistant in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2010; 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.