Provider Demographics
NPI:1174849426
Name:DE LEON, MONICA (PA)
Entity type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:
Last Name:DE LEON
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3989
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78502-3989
Mailing Address - Country:US
Mailing Address - Phone:956-362-2517
Mailing Address - Fax:956-362-2612
Practice Address - Street 1:2821 MICHAELANGELO DR STE 203
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-1423
Practice Address - Country:US
Practice Address - Phone:956-362-2517
Practice Address - Fax:956-362-2612
Is Sole Proprietor?:No
Enumeration Date:2010-04-12
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA-06361363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX345344101Medicaid
TX407863YNMFMedicare PIN