MEDICARE: BRUNO LEPORE LPC

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	101YP2500X	Professional Counselor	19385	TX

General Provider Information

NPI Number	:	1184704090
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRUNO LEPORE LPC

Provider Business Mailing Address
First Line	:	4611 BEE CAVES RD
Second Line	:	STE 1015
City	:	WEST LAKE HILLS
State	:	TX
Zip	:	78746-5220
Country	:	US
Telephone Number	:	512-740-9975
Fax Number	:	512-777-2537

Provider Business Practice Location Address
First Line	:	4611 BEE CAVES RD
Second Line	:	STE 1015
City	:	WEST LAKE HILLS
State	:	TX
Zip	:	78746-5220
Country	:	US
Telephone Number	:	512-740-9975
Fax Number	:	512-777-2537

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

Provider Enumeration Date	:	10/16/2006
Last Update Date	:	01/08/2017

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