Individual
GENCIE LAMONT LEONARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 HAVEN FOR HOPE WAY, SAN ANTONIO, TX 78207-1266
(210) 220-2330
Mailing address
1 HAVEN FOR HOPE WAY, SAN ANTONIO, TX 78207-1266
(210) 220-2330
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
941802
TX
363LP2300X
Primary Care Nurse Practitioner
Primary
1156510
TX
Other
Enumeration date
01/29/2024
Last updated
04/09/2024
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