Provider Demographics
NPI:1649502428
Name:MAURICE N. LEIBMAN, M.D. & ASSOCIATES
Entity type:Organization
Organization Name:MAURICE N. LEIBMAN, M.D. & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MIMI
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-275-2990
Mailing Address - Street 1:12727 KIMBERLEY LN
Mailing Address - Street 2:202
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-4047
Mailing Address - Country:US
Mailing Address - Phone:713-275-2990
Mailing Address - Fax:713-275-1694
Practice Address - Street 1:12727 KIMBERLEY LN
Practice Address - Street 2:202
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-4047
Practice Address - Country:US
Practice Address - Phone:713-275-2990
Practice Address - Fax:713-275-1694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-04
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF4926207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB24328Medicare UPIN
TXTXB113640Medicare PIN