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NPI Code Detail

MEDICARE: LEI EDEN

MEDICARE: LEI EDEN
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
1106S00000XBehavior TechnicianTX

General Provider Information

NPI Number : 1104768928
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEI EDEN
Provider Business Mailing Address
First Line : 9314 RYDER DR
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78254-2000
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6200 SARATOGA BLVD
Second Line :
City : CORPUS CHRISTI
State : TX
Zip : 78414-3421
Country : US
Telephone Number : 361-247-0614
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2026
Last Update Date : 04/09/2026

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Directions to “ LEI EDEN ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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