MEDICARE: DR. TODD HARVEY LEIKER DDS

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	1223G0001X	General Practice Dentistry	18360	TX

General Provider Information

NPI Number	:	1508858846
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TODD HARVEY LEIKER DDS

Provider Business Mailing Address
First Line	:	5735 PINELAKE CROSSING DR
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77379-2579
Country	:	US
Telephone Number	:	281-370-2189
Fax Number	:

Provider Business Practice Location Address
First Line	:	25412 INTERSTATE 45 N
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77386-1351
Country	:	US
Telephone Number	:	281-363-0500
Fax Number	:

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

Provider Enumeration Date	:	08/22/2005
Last Update Date	:	07/08/2007

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