Individual
MARIA L DELEON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1023 N MOUND ST, SUITE I, NACOGDOCHES, TX 75961
(936) 552-7400
(936) 552-7406
Mailing address
1023 N MOUND ST, SUITE I, NACOGDOCHES, TX 75961
(936) 552-7400
(936) 552-7406
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
K0452
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0052GK
BLUE CROSS/BLUE SHIELD
TX
05
—
030183001
—
TX
01
—
130023588
RAILROAD MEDICARE
TX
Enumeration date
09/26/2006
Last updated
06/02/2008
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