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General NPI Number Information
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NPI Number | 1669395497
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Entity Type | Organization
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Legal Business Name | LEADING EDGE HEALTH SERVICES
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Dates
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Enumeration Date | 07/30/2026
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Last Update Date | 07/30/2026
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Provider Practice Location Address
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Address Line | 5900 BALCONES DRIVE SUITE 100
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City | AUSTIN
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State | TX
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Zip | 78731
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Country | US
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Telephone | 330-696-4359
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Fax |
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Provider Business Mailing Address
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Address Line | 30 N GOULD ST STE N
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City | SHERIDAN
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State | WY
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Zip | 82801-6317
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Country | US
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Telephone | 330-696-4359
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | MR. MICHAEL PATRICK BRENNAN
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Credential |
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Telephone | 708-935-6165
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number |
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License Number State |
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