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NPI Code Detail

MEDICARE: DR. FRANCISCO ALONZO LEAL JR. MD

MEDICARE: DR. FRANCISCO ALONZO LEAL JR. MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianG5283TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
110021016OTHERTXAMERIGROUP
2107042OTHERTXSUPERIOR CHIPS
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1487658712
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. FRANCISCO ALONZO LEAL JR. MD
Provider Business Mailing Address
First Line : PO BOX 844658
Second Line :
City : DALLAS
State : TX
Zip : 75284-4658
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 600 NORTH PARK ST
Second Line :
City : BRENHAM
State : TX
Zip : 77833-2610
Country : US
Telephone Number : 979-836-6153
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2005
Last Update Date : 10/09/2020

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