Provider Demographics
NPI:1295738730
Name:GILNER, LEON IRA (MD)
Entity type:Individual
Prefix:DR
First Name:LEON
Middle Name:IRA
Last Name:GILNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1940 W SPIRIT CT
Mailing Address - Street 2:
Mailing Address - City:ANTHEM
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-1829
Mailing Address - Country:US
Mailing Address - Phone:623-374-2521
Mailing Address - Fax:623-374-7081
Practice Address - Street 1:605 E SAN ANTONIO ST
Practice Address - Street 2:SUITE 510E
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-6050
Practice Address - Country:US
Practice Address - Phone:623-374-2521
Practice Address - Fax:623-374-7081
Is Sole Proprietor?:No
Enumeration Date:2005-05-28
Last Update Date:2011-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ7497207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8A0022OtherBLUE CROSS
TXA52819Medicare UPIN
TX8J8399Medicare PIN