Provider Demographics
NPI:1033198585
Name:CABRERA, LEOPOLDO AMANSEC (MD, FAAP)
Entity Type:Individual
Prefix:DR
First Name:LEOPOLDO
Middle Name:AMANSEC
Last Name:CABRERA
Suffix:
Gender:M
Credentials:MD, FAAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 16367
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79490-6367
Mailing Address - Country:US
Mailing Address - Phone:806-722-4453
Mailing Address - Fax:806-722-4461
Practice Address - Street 1:542419TH ST
Practice Address - Street 2:STE 200
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79407-2106
Practice Address - Country:US
Practice Address - Phone:806-722-4453
Practice Address - Fax:806-722-4461
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2010-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK0658208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX122410706Medicaid
TX0096AVOtherBCBS
TX100128104OtherFIRSTCARE
TX0096AVOtherBCBS