Provider Demographics
NPI:1073258422
Name:DE LEON, ROSIO ADRIANA (OPTICIAN)
Entity Type:Individual
Prefix:
First Name:ROSIO
Middle Name:ADRIANA
Last Name:DE LEON
Suffix:
Gender:F
Credentials:OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3193 W ALTON GLOOR BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520-3509
Mailing Address - Country:US
Mailing Address - Phone:956-459-6007
Mailing Address - Fax:
Practice Address - Street 1:3193 W ALTON GLOOR BLVD STE A
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-3509
Practice Address - Country:US
Practice Address - Phone:956-459-6007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-30
Last Update Date:2022-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician