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NPI Code Detail

MEDICARE: ISIDRO G DE LEON DO

MEDICARE:   ISIDRO G DE 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
1207Q00000XFamily Medicine PhysicianK7714TX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00140711OTHERTXRAILROAD MEDICARE
35658340001OTHERTXMEDICARE NSC
58123N0OTHERTXMEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
48123N0OTHERTXBCBS

General Provider Information

NPI Number : 1942236856
Entity Type Code : Individual
Provider Name (Legal Business Name) : ISIDRO G DE LEON DO
Provider Business Mailing Address
First Line : 826 S MEYER ST
Second Line :
City : SEALY
State : TX
Zip : 77474-3433
Country : US
Telephone Number : 979-627-0795
Fax Number : 979-627-0799
Provider Business Practice Location Address
First Line : 826 S MEYER ST.
Second Line :
City : SEALY
State : TX
Zip : 77474-3433
Country : US
Telephone Number : 979-627-0795
Fax Number : 979-627-0799
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2006
Last Update Date : 08/28/2008

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Directions to “ ISIDRO G DE LEON DO” Practice Location

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