MEDICARE: LEISA MARIE DEUTSCH M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	0101254235	VA
2	207P00000X	Emergency Medicine Physician	S1078	TX

General Provider Information

NPI Number	:	1023320017
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEISA MARIE DEUTSCH M.D.

Provider Business Mailing Address
First Line	:	2921 SEA CHANNEL DR
Second Line	:
City	:	SEABROOK
State	:	TX
Zip	:	77586-1641
Country	:	US
Telephone Number	:	941-376-8219
Fax Number	:

Provider Business Practice Location Address
First Line	:	13000 SPACE CENTER BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77059-4724
Country	:	US
Telephone Number	:	941-376-8219
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2010
Last Update Date	:	05/21/2021

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Directions to “ LEISA MARIE DEUTSCH M.D.” Practice Location

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