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NPI Code Detail

MEDICARE: DR. ALAN C LESHNOWER M.D.

MEDICARE: DR. ALAN C LESHNOWER 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
1208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianG0756TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1G0756OTHERTXMEDICAL LICENSE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1801908942
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALAN C LESHNOWER M.D.
Provider Business Mailing Address
First Line : 5 SANTA FE PL
Second Line :
City : ODESSA
State : TX
Zip : 79765-8520
Country : US
Telephone Number : 432-563-5373
Fax Number : 866-730-6998
Provider Business Practice Location Address
First Line : 1220 W UNIVERSITY BLVD
Second Line :
City : ODESSA
State : TX
Zip : 79764-7118
Country : US
Telephone Number : 432-332-6600
Fax Number : 866-730-6998
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 04/22/2014

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