Provider Demographics
NPI:1245858406
Name:ESBAYHAT, LEANNE OMAR (PA-C)
Entity type:Individual
Prefix:
First Name:LEANNE
Middle Name:OMAR
Last Name:ESBAYHAT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 EAST FARM TO MARKET ROAD 544
Mailing Address - Street 2:#401
Mailing Address - City:MURPHY
Mailing Address - State:TX
Mailing Address - Zip Code:75094
Mailing Address - Country:US
Mailing Address - Phone:972-200-3199
Mailing Address - Fax:
Practice Address - Street 1:211 EAST FARM TO MARKET ROAD 544
Practice Address - Street 2:#401
Practice Address - City:MURPHY
Practice Address - State:TX
Practice Address - Zip Code:75094
Practice Address - Country:US
Practice Address - Phone:972-200-3199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-13
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA13773363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant