Provider Demographics
NPI:1265328504
Name:ANTONIO, LEILA (RN)
Entity type:Individual
Prefix:
First Name:LEILA
Middle Name:
Last Name:ANTONIO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:LEILA
Other - Middle Name:
Other - Last Name:LYNCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:11651 FM 1371
Mailing Address - Street 2:
Mailing Address - City:CHAPPELL HILL
Mailing Address - State:TX
Mailing Address - Zip Code:77426-5019
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11651 FM 1371
Practice Address - Street 2:
Practice Address - City:CHAPPELL HILL
Practice Address - State:TX
Practice Address - Zip Code:77426-5019
Practice Address - Country:US
Practice Address - Phone:979-277-1605
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-14
Last Update Date:2025-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1063835163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse