MEDICARE: MONICA DE LEON

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	183500000X	Pharmacist	59168	TX
2	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	59168	TX

General Provider Information

NPI Number	:	1831719954
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONICA DE LEON

Provider Business Mailing Address
First Line	:	695 REINERMAN ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77007-5234
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6425 FM 1464 RD
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77407-8287
Country	:	US
Telephone Number	:	281-277-2242
Fax Number	:

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

Provider Enumeration Date	:	04/18/2020
Last Update Date	:	06/27/2022

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Directions to “ MONICA DE LEON ” Practice Location

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