MEDICARE: DR. BRUCE LEONARD PHD, APRN, FNP

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	363LF0000X	Family Nurse Practitioner	AP108856	TX
2	163W00000X	Registered Nurse	654118	TX

General Provider Information

NPI Number	:	1225157456
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRUCE LEONARD PHD, APRN, FNP

Provider Business Mailing Address
First Line	:	6901 BERTNER AVE RM 763
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-3901
Country	:	US
Telephone Number	:	713-500-2167
Fax Number	:	713-500-2073

Provider Business Practice Location Address
First Line	:	6901 BERTNER AVE RM 763
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-3901
Country	:	US
Telephone Number	:	713-500-2167
Fax Number	:	713-500-2073

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

Provider Enumeration Date	:	03/28/2007
Last Update Date	:	05/15/2015

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