Organization
EDWARD W LEAHEY MD PROFESSIONAL ASSOCIATION
Active
Other names
ED LEAHEY MD PA
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA ABBY LEAHEY (OFFICE ADMINISTRATOR)
(832) 385-1631
Entity
Organization
Contact information
Practice address
4201 GARTH RD STE 100, BAYTOWN, TX 77521-3154
(281) 422-3113
(281) 427-6289
Mailing address
4201 GARTH RD STE 100, BAYTOWN, TX 77521-3154
(281) 422-3113
(281) 427-6289
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
E9763
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
009337
MEDICARE GROUP
TX
01
—
0095PV
BC/BS
TX
05
—
180530102
—
TX
01
—
DF1985
MEDICARE RR
TX
Enumeration date
04/10/2007
Last updated
09/15/2021
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