MEDICARE: DR. THEODORE PATRICK LEON DO

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
1	207R00000X	Internal Medicine Physician	266	NV

General Provider Information

NPI Number	:	1760590210
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THEODORE PATRICK LEON DO

Provider Business Mailing Address
First Line	:	2775 DURNESS CT
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89014-2228
Country	:	US
Telephone Number	:	702-456-3825
Fax Number	:	702-456-6795

Provider Business Practice Location Address
First Line	:	2920 N GREEN VALLEY PKWY
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89014-0406
Country	:	US
Telephone Number	:	702-456-3825
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/25/2006
Last Update Date	:	07/08/2007

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