Healthcare Provider Details

I. General information

NPI: 1437425436
Provider Name (Legal Business Name): SCOTT MATTHEW LEOPOLD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2012
Last Update Date: 07/10/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3533 S ALAMEDA ST
CORPUS CHRISTI TX
78411-1721
US

IV. Provider business mailing address

4602 OCEAN DR APT 4017
CORPUS CHRISTI TX
78412-2759
US

V. Phone/Fax

Practice location:
  • Phone: 361-694-4109
  • Fax:
Mailing address:
  • Phone: 860-798-8303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License NumberS2391
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License NumberS2391
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: