Provider Demographics
NPI:1003165259
Name:LEADING EDGE EMERGENCY PHYSICIANS, INC
Entity Type:Organization
Organization Name:LEADING EDGE EMERGENCY PHYSICIANS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MEDICAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:877-346-2211
Mailing Address - Street 1:PO BOX 733850
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-3850
Mailing Address - Country:US
Mailing Address - Phone:877-346-2211
Mailing Address - Fax:713-357-6821
Practice Address - Street 1:16088 SAN PEDRO AVE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-2251
Practice Address - Country:US
Practice Address - Phone:877-346-2211
Practice Address - Fax:713-357-6821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-04
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty