Provider Demographics
NPI:1083078877
Name:PLUMMER, LEILA ANNE (RAC(MI), LICAC(TX))
Entity Type:Individual
Prefix:
First Name:LEILA
Middle Name:ANNE
Last Name:PLUMMER
Suffix:
Gender:F
Credentials:RAC(MI), LICAC(TX)
Other - Prefix:
Other - First Name:LEILA
Other - Middle Name:ANNE
Other - Last Name:ALI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3440 RANCH TRL APT 2119
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-2441
Mailing Address - Country:US
Mailing Address - Phone:734-707-1198
Mailing Address - Fax:
Practice Address - Street 1:3440 RANCH TRL APT 2119
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-2441
Practice Address - Country:US
Practice Address - Phone:734-707-1198
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-08
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC01651171100000X, 171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist