Provider Demographics
NPI:1790971067
Name:LEONARD E DEAL, MD, PA
Entity Type:Organization
Organization Name:LEONARD E DEAL, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:E
Authorized Official - Last Name:DEAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-525-1668
Mailing Address - Street 1:12446 WEST AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-2530
Mailing Address - Country:US
Mailing Address - Phone:210-656-3600
Mailing Address - Fax:210-656-3603
Practice Address - Street 1:12446 WEST AVE STE 200
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-2530
Practice Address - Country:US
Practice Address - Phone:210-656-3600
Practice Address - Fax:210-656-3603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-20
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL8031207RC0200X, 207RP1001X, 207RS0012X
207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0025NCOtherBLUECROSS BLUESHIELD
TX177070301Medicaid
TXDO4567OtherMEDICARE RAILROAD
TX00762ZMedicare PIN