Individual
MARY OLIVIA DE LEON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
F.N.P.
Contact information
Practice address
4920 N. EXPRESSWAY,, ALTON GLOOR PLAZA#101, BROWNSVILLE, TX 78526
(956) 350-5530
(956) 350-5527
Mailing address
1474 W. PRICE RD, STE 7 BOX 536, BROWNSVILLE, TX 78520-8675
(956) 350-5530
(956) 350-5527
Taxonomy
Speciality
Code
Description
License number
State
364SP0200X
Pediatric Clinical Nurse Specialist
Primary
670508
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1336125046
—
TX
Enumeration date
11/24/2009
Last updated
10/07/2011
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