MEDICARE: MS. SAMANTHA ANN LEBLANC

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	106S00000X	Behavior Technician	RBT-25-502581	TX

General Provider Information

NPI Number	:	1275476772
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SAMANTHA ANN LEBLANC

Provider Business Mailing Address
First Line	:	813 ROYAL AVE
Second Line	:
City	:	PORT NECHES
State	:	TX
Zip	:	77651-3406
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	420 COUNTY ROAD 5015
Second Line	:
City	:	CLEVELAND
State	:	TX
Zip	:	77327-3627
Country	:	US
Telephone Number	:	281-432-7746
Fax Number	:

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

Provider Enumeration Date	:	04/10/2026
Last Update Date	:	04/10/2026

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