Provider Demographics
NPI:1407433089
Name:MANGIONE LEON, IVANA YAMILETT (MD)
Entity type:Individual
Prefix:
First Name:IVANA
Middle Name:YAMILETT
Last Name:MANGIONE LEON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 531968
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78553-1968
Mailing Address - Country:US
Mailing Address - Phone:338-874-8638
Mailing Address - Fax:
Practice Address - Street 1:3804 S JACKSON RD STE 2
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-6683
Practice Address - Country:US
Practice Address - Phone:956-296-3021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-28
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXW0221207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine