Organization
LEONIDES MEDRANO, MD,PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEONIDES MEDRANO M.D.,P.A. (PRESIDENT)
(409) 883-6052
Entity
Organization
Contact information
Practice address
3321 RIDGEMONT DR, ORANGE, TX 77630-4235
(409) 883-6052
(409) 883-9620
Mailing address
3321 RIDGEMONT DR, ORANGE, TX 77630-4235
(409) 883-6052
(409) 883-9620
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
J5407
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120509801
—
TX
01
—
1255300695
TYPE 1 NPI
TX
Enumeration date
08/01/2012
Last updated
08/01/2012
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