MEDICARE: DONALD L. LEASS, MD, FAAP, 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
1	261QP2300X	Primary Care Clinic/Center	E4884	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205813888
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DONALD L. LEASS, MD, FAAP, PA

Provider Business Mailing Address
First Line	:	17070 RED OAK DR
Second Line	:	SUITE 105
City	:	HOUSTON
State	:	TX
Zip	:	77090-2615
Country	:	US
Telephone Number	:	281-444-0075
Fax Number	:	281-444-0265

Provider Business Practice Location Address
First Line	:	17070 RED OAK DR
Second Line	:	SUITE 105
City	:	HOUSTON
State	:	TX
Zip	:	77090-2615
Country	:	US
Telephone Number	:	281-444-0075
Fax Number	:	281-444-0265

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DONALD L LEASS
Credential	:	M.D.
Telephone Number	:	281-444-0075

Provider Enumeration Date	:	12/27/2005
Last Update Date	:	08/22/2020

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