Provider Demographics
NPI:1649020769
Name:GOEHRING, LEAH (DO)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:GOEHRING
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:LEAH
Other - Middle Name:
Other - Last Name:GOEHRING-FORD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:1100 S LAMAR BLVD APT 3123
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-0049
Mailing Address - Country:US
Mailing Address - Phone:512-922-1298
Mailing Address - Fax:
Practice Address - Street 1:4301 W MARKHAM ST # 602
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-7101
Practice Address - Country:US
Practice Address - Phone:501-376-2211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-22
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program