Provider Demographics
NPI:1861919789
Name:NOYOLA, LEONARD BRIONES (CSFA)
Entity type:Individual
Prefix:
First Name:LEONARD
Middle Name:BRIONES
Last Name:NOYOLA
Suffix:
Gender:M
Credentials:CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 MADISON OAK DR STE 610
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-3924
Mailing Address - Country:US
Mailing Address - Phone:210-496-2222
Mailing Address - Fax:210-353-5367
Practice Address - Street 1:540 MADISON OAK DR STE 610
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-3924
Practice Address - Country:US
Practice Address - Phone:210-496-2222
Practice Address - Fax:210-353-5367
Is Sole Proprietor?:No
Enumeration Date:2017-08-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX177210246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX177210OtherCERTIFIED SURGICAL FIRST ASSISTANT