Provider Demographics
NPI:1033305974
Name:LEONHARDT, LARA (MD)
Entity Type:Individual
Prefix:DR
First Name:LARA
Middle Name:
Last Name:LEONHARDT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3701 W ALABAMA ST
Mailing Address - Street 2:SUITE 350
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-5290
Mailing Address - Country:US
Mailing Address - Phone:713-572-3200
Mailing Address - Fax:713-572-3204
Practice Address - Street 1:3701 W ALABAMA ST
Practice Address - Street 2:SUITE 350
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-5290
Practice Address - Country:US
Practice Address - Phone:713-572-3200
Practice Address - Fax:713-572-3204
Is Sole Proprietor?:No
Enumeration Date:2007-09-24
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM6983208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics