Active NPI
Leon George Theodore
- Social Worker
- Dallas, TX
National Provider Identifier
1205533650
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 108805
- Practice address
- 4144 Office Pkwy Apt 3203
Dallas, TX 75204-8803 - Phone
- (407) 547-6038
- NPI assigned
- Feb 15, 2023
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 108805 | TX | Primary |
Addresses
Primary practice location
4144 Office Pkwy Apt 3203
Dallas, TX 75204-8803
Mailing address
4144 Office Pkwy Apt 3203
Dallas, TX 75204-8803
Phone (407) 547-6038
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 |
|---|---|---|---|
| 108805 | TX | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1676419200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676592000000",
"number": "1205533650",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4144 OFFICE PKWY APT 3203",
"city": "DALLAS",
"state": "TX",
"postal_code": "752048803",
"telephone_number": "407-547-6038"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4144 OFFICE PKWY APT 3203",
"city": "DALLAS",
"state": "TX",
"postal_code": "752048803",
"telephone_number": "407-547-6038"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THEODORE",
"first_name": "LEON",
"middle_name": "GEORGE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-02-15",
"last_updated": "2023-02-17",
"certification_date": "2023-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "TX",
"license": "108805",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.