Healthcare Provider Details

I. General information

NPI: 1972126894
Provider Name (Legal Business Name): MARIE DANIELLE LEBLANC MD, FRCSC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DANIELLE LEBLANC MD, FRCSC

II. Dates (important events)

Enumeration Date: 05/27/2020
Last Update Date: 06/17/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3533 S ALAMEDA ST
CORPUS CHRISTI TX
78411-1721
US

IV. Provider business mailing address

600 E 5TH ST APT 1103
DES MOINES IA
50309-5415
US

V. Phone/Fax

Practice location:
  • Phone: 361-694-4700
  • Fax: 361-808-2156
Mailing address:
  • Phone: 515-805-9992
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License NumberMD-46942
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License NumberU5151
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: