Provider Demographics
NPI:1326664020
Name:LEONARD, TASHA SAMANTHA (AGACNP)
Entity Type:Individual
Prefix:
First Name:TASHA
Middle Name:SAMANTHA
Last Name:LEONARD
Suffix:
Gender:F
Credentials:AGACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6921 BRISBANE CT STE 220
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-7094
Mailing Address - Country:US
Mailing Address - Phone:281-980-1282
Mailing Address - Fax:281-980-2321
Practice Address - Street 1:6921 BRISBANE CT
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-7094
Practice Address - Country:US
Practice Address - Phone:713-527-5354
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-19
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP144214363L00000X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology