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Individual

BENJAMIN J LEEAH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
9601 SPUR 591, WILLIAM P. CLEMENTS, JR. UNIT, AMARILLO, TX 79107-9606
(806) 381-7080
(806) 381-0417
Mailing address
9601 SPUR 591, WILLIAM P. CLEMENTS, JR. UNIT, AMARILLO, TX 79107-9606
(806) 381-7080
(806) 381-0417

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
L5020
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0016KH
BCBS
TX
01
007614479
AETNA
TX
05
159401201
TX
01
680574937
TAX ID
TX
01
L5020
STATE MEDICAL LICENSE
TX
Enumeration date
07/15/2005
Last updated
03/07/2023
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