Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | L0373 | TX |
NPI | 1508849696 |
---|---|
Provider Name | Daniel James Leeman |
First Address | Austin, TX 78723-5818 |
Second Address | Austin, TX 78723 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/11/2005 |
Last Update Date | 17/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
038350701 | (05) | TX |
8A3850 | BCBS PROVIDER # (01) | TX |
G60460 | (02) | TX |