Provider Demographics
NPI:1649354085
Name:LEANNAH INVESTMENT PARTNERS, LTD
Entity type:Organization
Organization Name:LEANNAH INVESTMENT PARTNERS, LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICAL
Authorized Official - Prefix:
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-753-3121
Mailing Address - Street 1:PO BOX 250989
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-0989
Mailing Address - Country:US
Mailing Address - Phone:806-771-9988
Mailing Address - Fax:806-687-7318
Practice Address - Street 1:4500 HILLCREST RD STE 120
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-5419
Practice Address - Country:US
Practice Address - Phone:806-771-9988
Practice Address - Fax:806-687-7318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX178487801Medicaid