Provider Demographics
NPI:1740544261
Name:LEONG, SAMUEL K (LAC)
Entity type:Individual
Prefix:MR
First Name:SAMUEL
Middle Name:K
Last Name:LEONG
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1117 HERKIMER ST
Mailing Address - Street 2:SUITE 180
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-6745
Mailing Address - Country:US
Mailing Address - Phone:713-802-9811
Mailing Address - Fax:
Practice Address - Street 1:1117 HERKIMER ST
Practice Address - Street 2:SUITE 180
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-6745
Practice Address - Country:US
Practice Address - Phone:713-802-9811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-28
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC00804171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist