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NPI Code Detail

MEDICARE: LEAH MODESTE

MEDICARE: LEAH MODESTE
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
1183500000XPharmacist75455TX

General Provider Information

NPI Number : 1114875929
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEAH MODESTE
Provider Business Mailing Address
First Line : 6518 E LAURA CIR
Second Line :
City : BAYTOWN
State : TX
Zip : 77521-7321
Country : US
Telephone Number : 281-739-0301
Fax Number :
Provider Business Practice Location Address
First Line : 1415 CALIFORNIA ST
Second Line :
City : HOUSTON
State : TX
Zip : 77006-2602
Country : US
Telephone Number : 832-548-5100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/18/2026
Last Update Date : 03/18/2026

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Directions to “ LEAH MODESTE ” Practice Location

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