Provider Demographics
NPI:1083616197
Name:TECUANHUEY, LEOPOLDO (MD)
Entity Type:Individual
Prefix:DR
First Name:LEOPOLDO
Middle Name:
Last Name:TECUANHUEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:718 CUPPLES RD
Mailing Address - Street 2:SUITE102
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78237-4357
Mailing Address - Country:US
Mailing Address - Phone:210-438-0010
Mailing Address - Fax:210-438-0030
Practice Address - Street 1:718 CUPPLES ROAD
Practice Address - Street 2:SUITE 102
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78237-4354
Practice Address - Country:US
Practice Address - Phone:210-438-0010
Practice Address - Fax:210-438-0030
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-01
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ4555207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF65657Medicare UPIN
TX00009MMedicare PIN