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General NPI Number Information
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NPI Number | 1639823479
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Entity Type | Organization
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Legal Business Name | SARAH DIAZ DE LEON PLLC
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Dates
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Enumeration Date | 02/10/2022
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Last Update Date | 08/11/2022
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Provider Practice Location Address
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Address Line | 2768 PHARMACY RD
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City | RIO GRANDE CITY
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State | TX
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Zip | 78582-6201
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Country | US
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Telephone | 956-487-5621
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Fax |
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Provider Business Mailing Address
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Address Line | 904 MYRTLEWOOD DR
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City | FRIENDSWOOD
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State | TX
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Zip | 77546-2011
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MD
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Name | SARAH DIAZ DE LEON
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Credential | MD
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Telephone | 512-629-7629
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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