Individual ProviderMark W DelgadoPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address6601 Montana Ave, Suite G & H, El Paso, TX 79925-2155(915) 838-7604PECOS EnrollmentBased on the most recent information from CMS, provider Mark W Delgado does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1831492321Provider TypeIndividualFull NameDelgado, Mark WCredentialDPTGenderMaleSole ProprietorYesEnumeration Date12/6/2010Last Updated12/6/2010Contact InformationPractice LocationPractice Address6601 Montana Ave, Suite G & H, El Paso, TX 79925-2155Phone(915) 838-7604Fax(915) 772-4633Mailing LocationMailing Address6601 Montana Ave, Suite G & H, El Paso, TX 79925-2155Phone(915) 838-7604Fax(915) 772-4633Provider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense1201863TexasProvider IdentifiersIDDescriptionIssuerID149984001DescriptionMedicaidIssuerUnlistedTexasID207164901DescriptionMedicaidIssuerUnlistedTexas