Provider Demographics
NPI:1417339409
Name:ESTOFAN, LEONEL JORGE FAVIO (MD)
Entity Type:Individual
Prefix:DR
First Name:LEONEL
Middle Name:JORGE FAVIO
Last Name:ESTOFAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 749
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-1614
Mailing Address - Country:US
Mailing Address - Phone:956-362-8100
Mailing Address - Fax:956-362-8105
Practice Address - Street 1:2821 MICHAELANGELO DR STE 305
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-1405
Practice Address - Country:US
Practice Address - Phone:956-362-8100
Practice Address - Fax:956-362-8105
Is Sole Proprietor?:No
Enumeration Date:2015-06-25
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXS94992084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology