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Organization
ISIDRO G DELEON DO PA
Active
Organization
ISIDRO G DELEON DO PA
Active
Other names
Sealy Family Practice Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
ISIDRO G DE LEON D.O. (PRESIDENT/CEO)
(979) 627-0795
Entity
Organization
Contact information
Practice address
826 S MEYER ST, SEALY, TX 77474-3433
(979) 627-0795
(979) 627-0799
Mailing address
826 S MEYER ST, SEALY, TX 77474-3433
(979) 627-0795
(979) 627-0799
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
K7714
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00515R
BCBS
TX
05
—
144735101
—
TX
01
—
5658340001
MEDICARE NSC
TX
01
—
CH7975
RAILROAD MEDICARE
TX
Enumeration date
06/14/2006
Last updated
08/31/2010
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