Provider Demographics
NPI:1144753633
Name:DE LEON, JORGE CLINT (MD)
Entity Type:Individual
Prefix:
First Name:JORGE
Middle Name:CLINT
Last Name:DE LEON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:J.C.
Other - Middle Name:
Other - Last Name:DE LEON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:613 ELIZABETH ST STE 804
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78404-2231
Mailing Address - Country:US
Mailing Address - Phone:361-902-4343
Mailing Address - Fax:361-902-6000
Practice Address - Street 1:613 ELIZABETH ST STE 804
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78404-2231
Practice Address - Country:US
Practice Address - Phone:361-902-4343
Practice Address - Fax:361-902-6000
Is Sole Proprietor?:No
Enumeration Date:2017-04-11
Last Update Date:2024-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXU0327207X00000X, 207XX0801X
CODR.0068101207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Yes207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma