Healthcare Provider Details

I. General information

NPI: 1790971067
Provider Name (Legal Business Name): LEONARD E DEAL, MD, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2007
Last Update Date: 07/20/2022
Certification Date: 07/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12446 WEST AVE STE 200
SAN ANTONIO TX
78216-2530
US

IV. Provider business mailing address

12446 WEST AVE STE 200
SAN ANTONIO TX
78216-2530
US

V. Phone/Fax

Practice location:
  • Phone: 210-656-3600
  • Fax: 210-656-3603
Mailing address:
  • Phone: 210-656-3600
  • Fax: 210-656-3603

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberL8031
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberL8031
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License NumberL8031
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. LEONARD E DEAL
Title or Position: PHYSICIAN
Credential: MD
Phone: 210-525-1668