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General NPI Number Information
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NPI Number | 1134138589
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Entity Type | Individual
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Provider Name | GARY EVAN LEKA PH.D.
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Gender | Male
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 10/05/2016
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Provider Practice Location Address
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Address Line | 5109 S MCCOLL RD
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City | EDINBURG
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State | TX
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Zip | 78539-7885
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Country | US
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Telephone | 956-682-0385
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Fax | 956-682-0388
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Provider Business Mailing Address
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Address Line | 5109 S MCCOLL RD
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City | EDINBURG
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State | TX
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Zip | 78539-7885
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Country | US
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Telephone | 956-682-0385
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Fax | 956-682-0388
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 16196
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 31070
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License Number State | TX
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