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General NPI Number Information
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NPI Number | 1033063565
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Entity Type | Individual
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Provider Name | LILIANA DE LEON BONILLA MPH
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Gender | Female
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Dates
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Enumeration Date | 02/23/2026
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Last Update Date | 02/23/2026
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Provider Practice Location Address
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Address Line | 11621 COUNTY ROAD 166
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City | TYLER
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State | TX
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Zip | 75703-7492
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Country | US
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Telephone | 512-533-9555
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Fax |
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Provider Business Mailing Address
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Address Line | 9901 BRODIE LN # 679
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City | AUSTIN
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State | TX
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Zip | 78748-5803
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number | 9457
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License Number State | TX
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