MEDICARE: LEAH M SCHENK M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207VE0102X	Reproductive Endocrinology Physician	K6297	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	88002G	OTHER	TX	BLUE CROSS & BLUE SHIELD

General Provider Information

NPI Number	:	1699777953
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEAH M SCHENK M.D.

Provider Business Mailing Address
First Line	:	7900 FANNIN ST STE 4400
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-2949
Country	:	US
Telephone Number	:	713-512-7900
Fax Number	:	713-512-7829

Provider Business Practice Location Address
First Line	:	7900 FANNIN ST STE 4400
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-2949
Country	:	US
Telephone Number	:	713-512-7900
Fax Number	:	713-512-7829

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	09/11/2015

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