Individual provider Active NPI

Linda Diane Leary, M.D.

  • Epilepsy Physician
  • San Antonio, TX
National Provider Identifier
1669564118
Registry record updated Aug 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Epilepsy PhysicianTaxonomy code 2084E0001X
License
N3820 Issued in TX
Practice address
4502 Medical Dr
San Antonio, TX 78229-4402
Phone
(210) 358-5437
Fax
(210) 358-5476
NPI assigned
Sep 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X N3820 TX
Clinical Neurophysiology Physician 2084N0600X N3820 TX
Epilepsy Physician 2084E0001X N3820 TX Primary

Addresses

Primary practice location

4502 Medical Dr
San Antonio, TX 78229-4402

Mailing address

4502 Medical Dr
San Antonio, TX 78229-4402
Phone (210) 358-5437

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
I20090914000785 TX Practitioner - NeurologyPractitioner - Pediatric Medicine 2961558044 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
N3820TXMDClinical Neurophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Texas Health Science Center at San Antonio CurrentSince Aug 7, 2009 Accepting new patients
University of Texas Health Science Center at San Antonio Current Accepting new patients
University of Texas Health Science Center at San Antonio CurrentSince Aug 7, 2009 Accepting new patients
Bexar County Hospital District Past Accepting new patients
University of Texas Health Science Center at San Antonio Past Accepting new patients

Locations

8435 Wurzbach Rd
Ste 311
San Antonio, TX 78229

7703 Floyd Curl Dr
#7883
San Antonio, TX 78229
Phone (210) 450-0500

7703 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 450-3700

4502 Medical Dr
San Antonio, TX 78229
Phone (210) 358-3555

4647 Medical Dr
San Antonio, TX 78229
Phone (210) 358-2710

Interoperability endpoints

  • Direct secure messaging: lleary16313@direct.utmsa.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1669564118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4502 MEDICAL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294402",
            "telephone_number": "210-358-5437",
            "fax_number": "210-358-5476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4502 MEDICAL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294402",
            "telephone_number": "210-358-5437",
            "fax_number": "210-358-5476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEARY",
        "first_name": "LINDA",
        "middle_name": "DIANE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-29",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "TX",
            "license": "N3820",
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "TX",
            "license": "N3820",
            "primary": false
        },
        {
            "code": "2084E0001X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Epilepsy",
            "state": "TX",
            "license": "N3820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.