Provider Demographics
NPI:1952018723
Name:DELEON, BRENDA NICOLE
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:NICOLE
Last Name:DELEON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BRENDA
Other - Middle Name:NICOLE
Other - Last Name:LEAL-FLORES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3934 WOODHOUSE LN
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-4458
Mailing Address - Country:US
Mailing Address - Phone:361-944-2823
Mailing Address - Fax:
Practice Address - Street 1:801 LEOPARD ST
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78401-2421
Practice Address - Country:US
Practice Address - Phone:361-695-7200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-01
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX118732235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist