Organization
HEARTLAND ANESTHESIA PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEONARD GAYLON NEPPER DO (PRESIDENT)
(325) 641-1309
Entity
Organization
Contact information
Practice address
120 S PARK DR, BROWNWOOD, TX 76801-5918
(325) 641-1309
(325) 641-1310
Mailing address
PO BOX 2368, BROWNWOOD, TX 76804-2368
(325) 641-1309
(325) 641-1310
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
J9240
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00367T
MEDICARE GROUP #
TX
01
—
0051HQ
BLUE CROSS BLUE SHIELD
TX
05
—
150572901
—
TX
01
—
45D1086869
CLIA NUMBER - SA
TX
01
—
45D1087227
CLIA NUMBER - BWD
TX
01
—
CJ8608
RR MEDICARE GROUP #
TX
Enumeration date
10/05/2006
Last updated
10/29/2008
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