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LEODEZ
NPI 1255933115
General Practice in Tucker, GA

Active since November 14, 2020
4292 CHAMBLEE TUCKER RD, TUCKER, GA 30084(770) 718-1517 Get Directions Write a Review

NPPES record last updated: November 14, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Leodez NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LEODEZ (NPI 1255933115), doing business as Centro Medico San Lucas, is a healthcare organization registered as a general practice in Tucker, Georgia and active in the NPI registry since November 2020. The organization lists Byron Oswaldo Mata, Owner, as its authorized official.

NPPES Registry Identity

NPI1255933115
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NameLEODEZ
Location Address4292 CHAMBLEE TUCKER RDTucker, GA 30084-2103
Mailing Address3899 Grassland LoopLake Mary, FL 32746-4120 · (407) 394-2645
Phone(770) 718-1517
Organization SubpartYesParent: B Mata Llc
Authorized OfficialByron Oswaldo MataOwner · (786) 427-4450
Enumeration DateNovember 14, 2020
NPPES CertifiedNovember 14, 2020
✔ NPI 1255933115 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
Also ListedFamily Medicine · Adult MedicineTaxonomy 207QA0505X
Also ListedFamily Medicine · Geriatric MedicineTaxonomy 207QG0300X
4292 CHAMBLEE TUCKER RD, Tucker, GA 30084
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Other Names 1

Doing Business AsCentro Medico San Lucas

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BETSNAT MENGESHA
Physician Assistant
4292 CHAMBLEE TUCKER RD
TUCKER, GA 30084
Dekalb County (770) 718-1517
K-MATA LLC
Family Medicine
4292 CHAMBLEE TUCKER RD
TUCKER, GA 30084
Dekalb County (770) 718-1517

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Leodez's NPI number?

The NPI number for Leodez is 1255933115. It was assigned to this organization in the NPPES registry on November 14, 2020. The provider is doing business as Centro Medico San Lucas.

Where is Leodez located?

Leodez is located at 4292 Chamblee Tucker Rd, Tucker, GA 30084. The listed phone number is (770) 718-1517.

What is Leodez's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

When was this NPI record last updated?

The NPPES record for Leodez was last updated on November 14, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.