Healthcare Provider Details

I. General information

NPI: 1376411280
Provider Name (Legal Business Name): LEONIE MYRIAM SAMBE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2025
Last Update Date: 12/13/2025
Certification Date: 12/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

540 MADISON OAK DR STE 500
SAN ANTONIO TX
78258-3923
US

IV. Provider business mailing address

PO BOX 5730
BELFAST ME
04915-5700
US

V. Phone/Fax

Practice location:
  • Phone: 210-402-3700
  • Fax: 210-714-5086
Mailing address:
  • Phone: 888-402-7256
  • Fax: 888-902-1099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1216153
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: