MEDICARE: DR. LINDA ELOISE LEKAWSKI D.O.

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	207QA0505X	Adult Medicine Physician	H0556	TX

General Provider Information

NPI Number	:	1124180682
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LINDA ELOISE LEKAWSKI D.O.

Provider Business Mailing Address
First Line	:	4307 BERWICK PL
Second Line	:
City	:	COLLEGE STATION
State	:	TX
Zip	:	77845-4870
Country	:	US
Telephone Number	:	979-960-6037
Fax Number	:

Provider Business Practice Location Address
First Line	:	TEXAS A M UNIVERSITY STUDENT HEALTH SERVICES
Second Line	:	M.S. 1264
City	:	COLLEGE STATION
State	:	TX
Zip	:	77843-0001
Country	:	US
Telephone Number	:	979-458-8300
Fax Number	:

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

Provider Enumeration Date	:	12/14/2006
Last Update Date	:	07/08/2007

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