Individual
LEAH ROSE GARGUENA-BACUTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
7430 BARLITE BLVD, STE 104, SAN ANTONIO, TX 78224-1365
(210) 298-2529
(210) 977-8480
Mailing address
8702 MONUMENT OAK, BOERNE, TX 78015-6509
(210) 698-2436
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
K8163
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
155488301
—
TX
Enumeration date
06/01/2005
Last updated
11/02/2015
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