Healthcare Provider Details

I. General information

NPI: 1871114249
Provider Name (Legal Business Name): LEONARDO DAVID SALAZAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2020
Last Update Date: 08/28/2025
Certification Date: 08/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3411 GULF FWY
DICKINSON TX
77539-4118
US

IV. Provider business mailing address

3411 GULF FWY
DICKINSON TX
77539-4118
US

V. Phone/Fax

Practice location:
  • Phone: 281-256-7182
  • Fax:
Mailing address:
  • Phone: 281-256-7182
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberU5503
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License NumberU5503
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: