Doctor Name: | SAMUEL DE LEON |
NPI Number: | 1972884500 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 1000372 |
Business Practice Address: | 25658 N Fm 506 La Feria, TX - 785594260 |
Business Phone Number: | 9567973750 |
Business Fax Number: | 9567973795 |
Mailing Address: | 25658 N Fm 506, LA FERIA |
State: | TX |
Postal Code: | 785594260 |
Phone Number: | 9567973750 |
Fax Number: | 9567973795 |
NPI Enumeration Date: | 09/09/2011 |
NPI Last Update Date: | 10/31/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | 1000372 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |