Leodez

NPI #1255933115 in Tucker, Georgia

Provider Information

NPI Number: 1255933115
Entity Type: Organization
Organization Name: Leodez
Subpart: Yes (part of a larger organization)
Parent Organization: B MATA LLC
Primary Specialty: General Practice
Enumeration Date: Nov 14, 2020
Last Updated: Nov 14, 2020

Practice Location

Address: 4292 CHAMBLEE TUCKER RD
City: Tucker
State: Georgia
ZIP Code: 30084-2103
Phone: (770) 718-1517

Authorized Official

Name: DR. BYRON OSWALDO MATA, MD
Title: OWNER
Phone: (786) 427-4450

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine - Adult Medicine — Adult Medicine	207QA0505X
Family Medicine - Geriatric Medicine — Geriatric Medicine	207QG0300X
General Practice	208D00000X	Primary

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