Provider Demographics
NPI:1548548456
Name:DELEON, JOHN MICHAEL (PT)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:MICHAEL
Last Name:DELEON
Suffix:
Gender:M
Credentials:PT
Other - Prefix:MR
Other - First Name:J. MICHAEL
Other - Middle Name:
Other - Last Name:DELEON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT, MPT, MBA
Mailing Address - Street 1:2990 LEGACY DR
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-6066
Mailing Address - Country:US
Mailing Address - Phone:469-888-5205
Mailing Address - Fax:469-888-5222
Practice Address - Street 1:2990 LEGACY DR
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-6066
Practice Address - Country:US
Practice Address - Phone:469-888-5205
Practice Address - Fax:469-888-5222
Is Sole Proprietor?:No
Enumeration Date:2011-07-26
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11569652251N0400X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic