Active NPI
Juan Manuel De Leon, LSA-C/ROT
- Surgical Technologist
- San Benito, TX
National Provider Identifier
1376644245
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Technologist
- License
- SA00117
- Practice address
- 890 Comfort Dr
San Benito, TX 78586-2719 - Phone
- (956) 491-6905
- NPI assigned
- Sep 25, 2006
- 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 |
|---|---|---|---|---|
| Surgical Technologist | 246ZS0410X | SA00117 | TX | Primary |
Addresses
Primary practice location
890 Comfort Dr
San Benito, TX 78586-2719
Mailing address
890 Comfort Dr
San Benito, TX 78586-2719
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 |
|---|---|---|---|
| SA00117 | TX | MD | Surgical Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1376644245",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "890 COMFORT DR",
"city": "SAN BENITO",
"state": "TX",
"postal_code": "785862719"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "890 COMFORT DR",
"city": "SAN BENITO",
"state": "TX",
"postal_code": "785862719",
"telephone_number": "956-491-6905"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE LEON",
"first_name": "JUAN",
"middle_name": "MANUEL",
"credential": "LSA-C/ROT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "246ZS0410X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Technologist",
"state": "TX",
"license": "SA00117",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Benito, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.