Leonard Q Gruppo Jr., PA-C
Physician Assistant in Rockwall, TX. Individual provider (NPI-1).
NPI number1831189372
StatusActive
Last updated in NPPESMay 6, 2023
Details
- NPI
- 1831189372
- Entity type
- Individual (NPI-1)
- Name
- Mr. Leonard Q Gruppo Jr.
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 26, 2005
- Certification date
- May 6, 2023
- Last updated
- May 6, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | PA02885 | TX | Yes |
Practice location
810 E Ralph Hall Pkwy Unit 100Rockwall, TX 75032
Phone 469-402-3400
Mailing address
3851 Roger Brooke DrFort Sam Houston, TX 78234-4501
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