Individual provider · Type 1 NPI

Deloris Madim Rizqallah, DPM

Foot & Ankle Surgery Podiatrist · Longview, TX

NPI number 1245214246 Active

Practice location

701 E Marshall Ave, Suite 400
Longview, TX 75601-5659

Fax (903) 753-3671

Mailing address

PO Box 4207
Longview, TX 75606-4207

Specialties and licenses

TaxonomyCodeLicense
Foot & Ankle Surgery Podiatrist 213ES0103X016-005292 (IL)
Foot & Ankle Surgery Podiatrist Primary 213ES0103X1969 (TX)

Foot & Ankle Surgery Podiatrist: Definition to come...

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About NPI 1245214246

Deloris Madim Rizqallah, DPM's National Provider Identifier is 1245214246, issued on Dec 2, 2005. The primary taxonomy on file is Foot & Ankle Surgery Podiatrist (213ES0103X), and the practice location is in Longview, TX. The record was last updated on Jan 11, 2016.