Provider Demographics
NPI:1225157456
Name:LEONARD, BRUCE (PHD, APRN, FNP)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:
Last Name:LEONARD
Suffix:
Gender:M
Credentials:PHD, APRN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6901 BERTNER AVE RM 763
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-3901
Mailing Address - Country:US
Mailing Address - Phone:713-500-2167
Mailing Address - Fax:713-500-2073
Practice Address - Street 1:6901 BERTNER AVE RM 763
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-3901
Practice Address - Country:US
Practice Address - Phone:713-500-2167
Practice Address - Fax:713-500-2073
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2015-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP108856363LF0000X
TX654118163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse