Individual provider Active NPI

Leopoldo Carlos Cancio, MD

  • Surgical Critical Care Physician
  • Fort Sam Houston, TX
National Provider Identifier
1336120443
Registry record updated Aug 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
H4208 Issued in TX
Practice address
3400 Rawley E. Chambers Ave.
U.S. Army Institute of Surgical Research
Fort Sam Houston, TX 78234-6315
Phone
(210) 916-3301
NPI assigned
Nov 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Trauma Surgery Physician 2086S0127X H4208 TX
Surgical Critical Care Physician 2086S0102X H4208 TX Primary

Addresses

Primary practice location

3400 Rawley E. Chambers Ave.
U.S. Army Institute of Surgical Research
Fort Sam Houston, TX 78234-6315

Mailing address

3400 Rawley E. Chambers Ave.
U.S. Army Institute of Surgical Research
Fort Sam Houston, TX 78234-6315
Phone (210) 916-3301

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131227000913 TX Order and Referring Only - General SurgeryPractitioner - General Surgery 6406083203

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
H4208TXMDTrauma Surgery Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723766400000",
    "number": "1336120443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 RAWLEY E. CHAMBERS AVE.",
            "address_2": "U.S. ARMY INSTITUTE OF SURGICAL RESEARCH",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782346315",
            "telephone_number": "210-916-3301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 RAWLEY E. CHAMBERS AVE.",
            "address_2": "U.S. ARMY INSTITUTE OF SURGICAL RESEARCH",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782346315",
            "telephone_number": "210-916-3301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANCIO",
        "first_name": "LEOPOLDO",
        "middle_name": "CARLOS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-07",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "TX",
            "license": "H4208",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "TX",
            "license": "H4208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Sam Houston, TX

Sources for this page

Verify at the official NPI Registry.