Individual
EDMOND JOSEPH LEROUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M. D.
Contact information
Practice address
1933 NE LOOP 410, SAN ANTONIO, TX 78217
(210) 804-6000
(210) 804-6069
Mailing address
1933 NE LOOP 410, SAN ANTONIO, TX 78217-5320
(210) 804-6001
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
43825
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114240801
—
TX
01
—
85V352
BCBS
TX
Enumeration date
09/27/2006
Last updated
12/08/2007
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