Individual
JUAN MANUEL DE LEON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LSA-C/ROT
Contact information
Practice address
890 COMFORT DR, SAN BENITO, TX 78586-2719
(956) 491-6905
Mailing address
890 COMFORT DR, SAN BENITO, TX 78586-2719
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
SA00117
TX
Other
Enumeration date
09/25/2006
Last updated
07/08/2007
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