Provider Demographics
NPI:1558689554
Name:LONGORIA, LEONARDO ARTURO (MD)
Entity Type:Individual
Prefix:
First Name:LEONARDO
Middle Name:ARTURO
Last Name:LONGORIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1404 LOST PADRE MINE DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-2820
Mailing Address - Country:US
Mailing Address - Phone:915-526-7407
Mailing Address - Fax:
Practice Address - Street 1:2000B TRANS MOUNTAIN RD STE 260
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79911-3600
Practice Address - Country:US
Practice Address - Phone:915-328-4793
Practice Address - Fax:915-591-9215
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXR1407207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXR1407OtherTEXAS MEDICAL LICENSE