Individual
MARY J LEAHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1200 CARL RAMERT DR, YOAKUM, TX 77995-4868
(361) 293-2321
(361) 293-6172
Mailing address
222 THIELE RD, YOAKUM, TX 77995-2130
(361) 550-5549
(361) 741-2354
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
538626
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
132831209
—
TX
05
—
132831215
—
TX
01
—
8311UC
BCBS TX
—
01
—
83648U
BCBSTX
TX
Enumeration date
05/04/2006
Last updated
08/09/2013
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