Provider Demographics
NPI:1407975048
Name:SALCEDO, LEONARDO ERNESTO (MD)
Entity Type:Individual
Prefix:
First Name:LEONARDO
Middle Name:ERNESTO
Last Name:SALCEDO
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:PO BOX 4449
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78502-4449
Mailing Address - Country:US
Mailing Address - Phone:956-362-2171
Mailing Address - Fax:956-661-2204
Practice Address - Street 1:5525 DOCTORS DR
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-5520
Practice Address - Country:US
Practice Address - Phone:956-362-8740
Practice Address - Fax:956-362-8795
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ9796207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX123954307Medicaid
TX361585YUQGMedicare PIN
TX123954305Medicaid
TX123954307Medicaid