Provider Demographics
NPI:1184332322
Name:DE LEON, BIANCA (SLP)
Entity type:Individual
Prefix:
First Name:BIANCA
Middle Name:
Last Name:DE LEON
Suffix:
Gender:
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10650 CULEBRA RD # 104-233
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-4949
Mailing Address - Country:US
Mailing Address - Phone:210-845-5800
Mailing Address - Fax:
Practice Address - Street 1:10650 CULEBRA RD # 104-233
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-4949
Practice Address - Country:US
Practice Address - Phone:210-845-5800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-07
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX118148235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist