Isidro G Deleon DO PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

K7714 Issued in TX

Legal business name

ISIDRO G DELEON DO PA

Doing business as

Sealy Family Practice Clinic

Practice address

826 S Meyer St
Sealy, TX 77474-3433

Phone

(979) 627-0795

Fax

(979) 627-0799

NPI assigned

Jun 14, 2006

Organization subpart

No

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

Authorized official

Name

Isidro G De Leon, D.O.NPI 1942236856

Title

President/Ceo

Phone

(979) 627-0795

Specialties & licenses 1

Addresses

Other identifiers 5

Other names 1

• Sealy Family Practice Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Isidro G De Leon, DO

  • Family Medicine Physician
  • Sealy, TX
  • NPI 1942236856
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283212800000",
    "number": "1528001526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "826 S MEYER ST",
            "city": "SEALY",
            "state": "TX",
            "postal_code": "774743433",
            "telephone_number": "979-627-0795",
            "fax_number": "979-627-0799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "826 S MEYER ST",
            "city": "SEALY",
            "state": "TX",
            "postal_code": "774743433",
            "telephone_number": "979-627-0795",
            "fax_number": "979-627-0799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISIDRO G DELEON DO PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-14",
        "last_updated": "2010-08-31",
        "status": "A",
        "authorized_official_last_name": "DE LEON",
        "authorized_official_first_name": "ISIDRO",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "979-627-0795",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K7714",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "144735101",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00515R",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NSC",
            "identifier": "5658340001",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "00515R",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CH7975",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sealy Family Practice Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Family Medicine Physician in Sealy, TX
• Providers in Sealy, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.