Active NPI
Mary Olivia De Leon, F.N.P.
- Pediatric Clinical Nurse Specialist
- Brownsville, TX
National Provider Identifier
1609104066
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Clinical Nurse Specialist
- License
- 670508
- Practice address
- 4920 N. Expressway,
Alton Gloor Plaza#101
Brownsville, TX 78526 - Phone
- (956) 350-5530
- Fax
- (956) 350-5527
- NPI assigned
- Nov 24, 2009
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatric Clinical Nurse Specialist | 364SP0200X | 670508 | TX | Primary |
Addresses
Primary practice location
4920 N. Expressway,
Alton Gloor Plaza#101
Brownsville, TX 78526
Mailing address
1474 W. Price Rd
Ste 7 Box 536
Brownsville, TX 78520-8675
Phone (956) 350-5530
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336125046 | Medicaid | TX |
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 |
|---|---|---|---|
| 670508 | TX | MD | Pediatric Clinical Nurse Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sunshine Pediatrics LLP | Past | Accepting new patients | |
| Tania Jalil, M.D., P.a. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pediatric Critical Care Medicine Physician
- Brownsville, TX
- NPI 1427135987
-
- Pediatrics Physician
- Brownsville, TX
- NPI 1679711329
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1259020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317945600000",
"number": "1609104066",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1474 W. PRICE RD",
"address_2": "STE 7 BOX 536",
"city": "BROWNSVILLE",
"state": "TX",
"postal_code": "785208675",
"telephone_number": "956-350-5530",
"fax_number": "956-350-5527"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4920 N. EXPRESSWAY,",
"address_2": "ALTON GLOOR PLAZA#101",
"city": "BROWNSVILLE",
"state": "TX",
"postal_code": "78526",
"telephone_number": "956-350-5530",
"fax_number": "956-350-5527"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE LEON",
"first_name": "MARY",
"middle_name": "OLIVIA",
"credential": "F.N.P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-11-24",
"last_updated": "2011-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "364SP0200X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist, Pediatrics",
"state": "TX",
"license": "670508",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1336125046",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brownsville, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.