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General NPI Number Information
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NPI Number | 1295058295
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Entity Type | Organization
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Legal Business Name | PABLO LEONARDO MD PA
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Dates
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Enumeration Date | 03/04/2010
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Last Update Date | 06/05/2014
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Provider Practice Location Address
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Address Line | 2301 S CLEAR CREEK RD SUITE 202
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City | KILLEEN
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State | TX
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Zip | 76549-4143
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Country | US
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Telephone | 254-526-0404
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Fax | 254-526-9673
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Provider Business Mailing Address
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Address Line | 2301 S CLEAR CREEK RD SUITE 202
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City | KILLEEN
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State | TX
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Zip | 76549-4143
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Country | US
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Telephone | 254-526-0404
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Fax | 254-526-9673
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Authorized Official
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Title or Position | OWNDER
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Name | DR. PABLO LEONARDO
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Credential | M.D.
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Telephone | 254-526-0404
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | G1945
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License Number State | TX
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