Provider Demographics
NPI:1629546635
Name:LEIJA, LAURA ANN (RN)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:ANN
Last Name:LEIJA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1708 ALBANS RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77005-1704
Mailing Address - Country:US
Mailing Address - Phone:713-591-7871
Mailing Address - Fax:
Practice Address - Street 1:1708 ALBANS RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77005-1704
Practice Address - Country:US
Practice Address - Phone:713-591-7871
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-07
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX903160163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse