Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | G6160 | TX |
NPI | 1235145301 |
---|---|
Provider Name | Frank Deleon |
First Address | Fort Worth, TX 76104-7639 |
Second Address | Fort Worth, TX 76104-2820 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2006 |
Last Update Date | 10/04/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
137568511 | (05) | TX |
8U1337 | BCBS (01) | TX |
C15126 | (02) | TX |