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General NPI Number Information
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NPI Number | 1457845745
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Entity Type | Individual
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Provider Name | JOHN MICHEAL LEONDIKE FNP
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Gender | Male
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Dates
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Enumeration Date | 06/19/2018
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Last Update Date | 02/23/2023
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Provider Practice Location Address
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Address Line | 12804 GULF FWY STE 200
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City | HOUSTON
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State | TX
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Zip | 77034-4850
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Country | US
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Telephone | 832-472-0135
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Fax |
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Provider Business Mailing Address
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Address Line | 1907 WHITE FEATHER TRL
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City | CROSBY
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State | TX
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Zip | 77532-3281
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Country | US
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Telephone | 32-472-0135
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Fax |
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | AP137791
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License Number State | TX
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