Provider Demographics
NPI:1578925970
Name:LEONARD WEISS, PLLC
Entity Type:Organization
Organization Name:LEONARD WEISS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:
Authorized Official - Last Name:WEISS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-583-8507
Mailing Address - Street 1:3006 BEE CAVES RD
Mailing Address - Street 2:D-203
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-5588
Mailing Address - Country:US
Mailing Address - Phone:512-646-0880
Mailing Address - Fax:512-646-0879
Practice Address - Street 1:3006 BEE CAVES RD
Practice Address - Street 2:D-203
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-5588
Practice Address - Country:US
Practice Address - Phone:512-646-0880
Practice Address - Fax:512-646-0879
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-24
Last Update Date:2016-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP18332084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX26BDJBPMedicare UPIN