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Individual

DR. CHARLES THOMAS LEACH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
333 N SANTA ROSA ST, SAN ANTONIO, TX 78207-3108
(210) 704-3391
Mailing address
315 N. SAN SABA, STE.1003, CHILDREN'S HOSPITAL OF SAN ANTONIO, SAN ANTONIO, TX 78207
(210) 704-3391

Taxonomy

Speciality
Code
Description
License number
State
2080P0208X
Pediatric Infectious Diseases Physician
Primary
H6882
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
103034801
TX
Enumeration date
08/24/2006
Last updated
02/12/2015
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