MEDICARE: MS. LEONARD I. CANCIO OTR/L, CHT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225XH1200X	Hand Occupational Therapist	108759	TX

General Provider Information

NPI Number	:	1689657728
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LEONARD I. CANCIO OTR/L, CHT

Provider Business Mailing Address
First Line	:	21018 CACTUS CLF
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78258
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3851 ROGER BROOKE DR
Second Line	:
City	:	FT. SAM HOUSTON
State	:	TX
Zip	:	78234-6200
Country	:	US
Telephone Number	:	210-916-5805
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/22/2005
Last Update Date	:	07/08/2007

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