Healthcare Provider Details

I. General information

NPI: 1932297942
Provider Name (Legal Business Name): THOMAS A. LEONG, M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 04/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6118 PARKWAY DR
CORPUS CHRISTI TX
78414-2455
US

IV. Provider business mailing address

PO BOX 6818
CORPUS CHRISTI TX
78466-6818
US

V. Phone/Fax

Practice location:
  • Phone: 361-883-2000
  • Fax:
Mailing address:
  • Phone: 361-883-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License NumberM4854
License Number StateTX

VIII. Authorized Official

Name: THOMAS A. LEONG
Title or Position: PROFESSIONAL ASSOCIATION
Credential: M.D., P.A.
Phone: 361-883-2000