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General NPI Number Information
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NPI Number | 1568804334
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Entity Type | Individual
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Provider Name | MARIO FERNANDO LEON PAREDES DDS, MSD
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Gender | Male
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Dates
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Enumeration Date | 07/22/2013
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Last Update Date | 10/25/2016
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Provider Practice Location Address
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Address Line | 2380 S MACGREGOR WAY APT 229
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City | HOUSTON
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State | TX
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Zip | 77021-1159
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Country | US
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Telephone | 860-549-3998
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Fax |
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Provider Business Mailing Address
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Address Line | 2380 S MACGREGOR WAY APT 229
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City | HOUSTON
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State | TX
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Zip | 77021-1159
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Country | US
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Telephone | 860-549-3998
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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 | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 32475
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License Number State | TX
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