Provider Demographics
NPI:1518063072
Name:HARVEY, LEIGH A (DPM)
Entity Type:Individual
Prefix:
First Name:LEIGH
Middle Name:A
Last Name:HARVEY
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6260 DELAWARE ST
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77706-7602
Mailing Address - Country:US
Mailing Address - Phone:409-899-1538
Mailing Address - Fax:409-899-2120
Practice Address - Street 1:6260 DELAWARE ST
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77706-7602
Practice Address - Country:US
Practice Address - Phone:409-899-1538
Practice Address - Fax:409-899-2120
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTX1489213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX045841603Medicaid
TX0538160001Medicare NSC
TX045841603Medicaid
U81365Medicare UPIN