Active NPI
Leroy Medrano, AUD
- Audiologist
- Fort Bliss, TX
National Provider Identifier
1104792274
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 14235918-4101
- Practice address
- 11335 SSG Sims St
Fort Bliss, TX 79918-8033 - Phone
- (765) 299-1785
- NPI assigned
- Oct 15, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 14235918-4101 | UT | Primary |
Addresses
Primary practice location
11335 SSG Sims St
Fort Bliss, TX 79918-8033
Mailing address
200 N Mesa Hills Dr Apt 1313
El Paso, TX 79912-4856
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14235918-4101 | UT | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1760486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1760486400000",
"number": "1104792274",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 N MESA HILLS DR APT 1313",
"city": "EL PASO",
"state": "TX",
"postal_code": "799124856"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11335 SSG SIMS ST",
"city": "FORT BLISS",
"state": "TX",
"postal_code": "799188033",
"telephone_number": "765-299-1785"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDRANO",
"first_name": "LEROY",
"credential": "AUD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-10-15",
"last_updated": "2025-10-15",
"certification_date": "2025-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "UT",
"license": "14235918-4101",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Bliss, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.