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General NPI Number Information
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NPI Number | 1497972590
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Entity Type | Organization
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Legal Business Name | DR.DELEON'S WOMEN'S HEALTHCARE CLINIC PA
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 01/28/2014
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Provider Practice Location Address
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Address Line | 3705 LAKEVIEW PKWY STE 215
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City | ROWLETT
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State | TX
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Zip | 75088-4179
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Country | US
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Telephone | 972-463-1811
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Fax | 972-463-1927
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Provider Business Mailing Address
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Address Line | PO BOX 2843
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City | ROWLETT
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State | TX
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Zip | 75030-2843
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Country | US
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Telephone | 972-463-1811
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Fax | 972-463-1927
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LUIS DELEON USUGA
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Credential | M.D.
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Telephone | 972-463-1811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | K6945
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License Number State | TX
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