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Individual
ISIDRO G DE LEON
Active
Individual
ISIDRO G DE LEON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
K7714
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
144736901
—
TX
01
—
5658340001
MEDICARE NSC
TX
01
—
8123N0
BCBS
TX
01
—
P00140711
RAILROAD MEDICARE
TX
Enumeration date
06/23/2006
Last updated
08/28/2008
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