Healthcare Provider Details

I. General information

NPI: 1871421016
Provider Name (Legal Business Name): LEO SHARRON LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2026
Last Update Date: 05/09/2026
Certification Date: 05/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1404 N GONZALES ST
CUERO TX
77954-2418
US

IV. Provider business mailing address

1404 N GONZALES ST
CUERO TX
77954-2418
US

V. Phone/Fax

Practice location:
  • Phone: 361-648-1634
  • Fax:
Mailing address:
  • Phone: 361-648-1634
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number81438
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: