Provider Demographics
NPI:1811553258
Name:CARTER, LEONARD ALVIN JR
Entity Type:Individual
Prefix:MR
First Name:LEONARD
Middle Name:ALVIN
Last Name:CARTER
Suffix:JR
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 1:1720 N MCDONALD ST
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-8229
Mailing Address - Country:US
Mailing Address - Phone:972-562-7969
Mailing Address - Fax:972-542-6463
Practice Address - Street 1:1720 N MCDONALD ST
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-8229
Practice Address - Country:US
Practice Address - Phone:972-562-7969
Practice Address - Fax:972-542-6463
Is Sole Proprietor?:No
Enumeration Date:2019-05-10
Last Update Date:2019-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX109526225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist