Provider Demographics
NPI:1023581006
Name:LEON S TIO MD PA
Entity type:Organization
Organization Name:LEON S TIO MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:PHUAH
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:214-336-7643
Mailing Address - Street 1:800 8TH AVE STE 506
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-2604
Mailing Address - Country:US
Mailing Address - Phone:817-386-3632
Mailing Address - Fax:866-245-0073
Practice Address - Street 1:800 8TH AVE STE 506
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-2604
Practice Address - Country:US
Practice Address - Phone:817-386-2679
Practice Address - Fax:817-386-3632
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-02
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty