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General NPI Number Information
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NPI Number | 1669363719
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Entity Type | Individual
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Provider Name | NICHOLAS PREJEAN LEBLANC PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 07/15/2025
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Last Update Date | 07/15/2025
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Provider Practice Location Address
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Address Line | 2395 BULVERDE RD STE 101
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City | BULVERDE
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State | TX
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Zip | 78163-4572
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Country | US
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Telephone | 830-980-6880
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Fax | 830-980-6881
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Provider Business Mailing Address
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Address Line | 18211 REDRIVER SONG
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City | SAN ANTONIO
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State | TX
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Zip | 78259-3558
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Country | US
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Telephone |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1406986
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License Number State | TX
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