Provider Demographics
NPI:1760749881
Name:LEONG, AMELIA (MD)
Entity Type:Individual
Prefix:
First Name:AMELIA
Middle Name:
Last Name:LEONG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:AMELIA
Other - Middle Name:WIKE
Other - Last Name:FREEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2315 WORDSWORTH ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2027
Mailing Address - Country:US
Mailing Address - Phone:713-857-3551
Mailing Address - Fax:
Practice Address - Street 1:ONE BAYLOR PLAZA,
Practice Address - Street 2:ROOM 022D
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030
Practice Address - Country:US
Practice Address - Phone:713-857-3551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-13
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10043100207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine