Provider Demographics
NPI:1437817483
Name:LEBLANC, MICHAEL STEELE
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:STEELE
Last Name:LEBLANC
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28203 EAGLE CV
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:TX
Mailing Address - Zip Code:77355-5363
Mailing Address - Country:US
Mailing Address - Phone:832-538-9789
Mailing Address - Fax:
Practice Address - Street 1:28203 EAGLE CV
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:TX
Practice Address - Zip Code:77355-5363
Practice Address - Country:US
Practice Address - Phone:832-538-9789
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-07
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program