Individual
JUSTIN RAY LEAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
206 E LOCUST ST, SAN ANTONIO, TX 78212-3954
(210) 572-2530
(210) 212-7234
Mailing address
206 E. LOCUST ST., SAN ANTONIO, TX 78212
(210) 572-2530
(210) 212-7234
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
H921060
TX
171WH0202X
Home Modifications Contractor
TS921473
TX
Other
Enumeration date
09/15/2011
Last updated
09/15/2011
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