Healthcare Provider Details

I. General information

NPI: 1881217495
Provider Name (Legal Business Name): MEDINA-LEON AND ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2020
Last Update Date: 05/19/2020
Certification Date: 05/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

391 EL DORADO BLVD STE A
WEBSTER TX
77598-2322
US

IV. Provider business mailing address

391 EL DORADO BLVD STE A
WEBSTER TX
77598-2322
US

V. Phone/Fax

Practice location:
  • Phone: 281-686-7176
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MARITZA LEON- SANCHEZ
Title or Position: FNP
Credential:
Phone: 832-240-4261