Provider Demographics
NPI:1083690986
Name:LEON, DIEGO (DC)
Entity Type:Individual
Prefix:DR
First Name:DIEGO
Middle Name:
Last Name:LEON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9888 BELLAIRE BLVD
Mailing Address - Street 2:SUITE 122
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-3429
Mailing Address - Country:US
Mailing Address - Phone:713-771-9004
Mailing Address - Fax:713-771-7033
Practice Address - Street 1:9888 BELLAIRE BLVD
Practice Address - Street 2:SUITE 122
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-3429
Practice Address - Country:US
Practice Address - Phone:713-771-9004
Practice Address - Fax:713-995-7902
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-22
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10165111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor