Provider Demographics
NPI:1447883210
Name:LEON, EDNA (LVN)
Entity type:Individual
Prefix:MRS
First Name:EDNA
Middle Name:
Last Name:LEON
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13133 SAKER DR
Mailing Address - Street 2:
Mailing Address - City:HORIZON CITY
Mailing Address - State:TX
Mailing Address - Zip Code:79928-6211
Mailing Address - Country:US
Mailing Address - Phone:915-820-4250
Mailing Address - Fax:
Practice Address - Street 1:13133 SAKER DR
Practice Address - Street 2:
Practice Address - City:HORIZON CITY
Practice Address - State:TX
Practice Address - Zip Code:79928-6211
Practice Address - Country:US
Practice Address - Phone:915-820-4250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-19
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX226883164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse