Healthcare Provider Details

I. General information

NPI: 1548548456
Provider Name (Legal Business Name): JOHN MICHAEL DELEON PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: J. MICHAEL DELEON PT, MPT, MBA

II. Dates (important events)

Enumeration Date: 07/26/2011
Last Update Date: 07/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2990 LEGACY DR
FRISCO TX
75034-6066
US

IV. Provider business mailing address

2990 LEGACY DR
FRISCO TX
75034-6066
US

V. Phone/Fax

Practice location:
  • Phone: 469-888-5205
  • Fax: 469-888-5222
Mailing address:
  • Phone: 469-888-5205
  • Fax: 469-888-5222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number1156965
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number1156965
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: