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General NPI Number Information
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NPI Number | 1437582236
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Entity Type | Organization
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Legal Business Name | LEON SPRINGS DENTAL CENTER, PA
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Dates
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Enumeration Date | 08/15/2013
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Last Update Date | 07/07/2015
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Provider Practice Location Address
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Address Line | 25235 W INTERSTATE 10 SUITE 201
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City | SAN ANTONIO
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State | TX
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Zip | 78257-9550
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Country | US
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Telephone | 210-698-1010
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Fax | 210-698-1078
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Provider Business Mailing Address
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Address Line | 25235 W INTERSTATE 10 SUITE 201
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City | SAN ANTONIO
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State | TX
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Zip | 78257-9550
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Country | US
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Telephone | 210-698-1010
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Fax | 210-698-1078
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Authorized Official
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Title or Position | OWNER
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Name | DR. CAROLYN BOWMAN WALKER
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Credential | DDS
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Telephone | 210-698-1010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 20536
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License Number State | TX
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