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General NPI Number Information
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NPI Number | 1083886303
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Entity Type | Organization
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Legal Business Name | GRACIELA M LEIJA MD PA
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Dates
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Enumeration Date | 03/26/2008
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Last Update Date | 06/22/2023
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Provider Practice Location Address
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Address Line | 95 E. PRICE RD. STE. E
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City | BROWNSVILLE
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State | TX
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Zip | 78521-3565
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Country | US
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Telephone | 956-504-4800
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Fax | 956-504-4801
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Provider Business Mailing Address
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Address Line | 95 E. PRICE RD. STE. E
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City | BROWNSVILLE
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State | TX
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Zip | 78521-3565
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Country | US
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Telephone | 956-504-4800
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Fax | 956-584-4801
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Authorized Official
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Title or Position | OWNER
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Name | DR. GRACIELA M LEIJA
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Credential | M.D.
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Telephone | 956-504-4800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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