Individual
DR. LEONARD M BOHANON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
101 PINE MANOR DR, OAK RIDGE NORTH, TX 77385-9059
(832) 628-5253
Mailing address
101 PINE MANOR DR, OAK RIDGE NORTH, TX 77385-9059
(832) 628-5253
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2-2536
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0015DL
BLUE CROSS/BLUE SHIELD
TX
05
—
030445301
—
TX
01
—
138628
VALUE OPTIONS
—
01
—
225505
COMPSYCH
—
01
—
48145516
WAUSAU
—
Enumeration date
08/03/2006
Last updated
09/19/2025
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