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NPI Code Detail

MEDICARE: ALAN C LESHNOWER MD, PA

MEDICARE: ALAN C LESHNOWER MD, PA
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
1208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianG0756TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1G0756OTHERTXMEDICAL LICENSE

General Provider Information

NPI Number : 1033447065
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALAN C LESHNOWER MD, PA
Provider Business Mailing Address
First Line : 1220 W UNIVERSITY BLVD
Second Line :
City : ODESSA
State : TX
Zip : 79764-7118
Country : US
Telephone Number : 432-332-6600
Fax Number : 866-673-0699
Provider Business Practice Location Address
First Line : 1220 W UNIVERSITY BLVD
Second Line :
City : ODESSA
State : TX
Zip : 79764-7118
Country : US
Telephone Number : 432-332-6600
Fax Number : 866-730-6998
Authorized Official
Title or Position : PRESIDENT
Name : ALAN C LESHNOWER
Credential : MD
Telephone Number : 432-332-6600
Provider Enumeration Date : 12/02/2009
Last Update Date : 04/22/2014

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