Provider Demographics
NPI:1780970087
Name:COLEN, LEONORA M (LICENSED MIDWIFE)
Entity type:Individual
Prefix:
First Name:LEONORA
Middle Name:M
Last Name:COLEN
Suffix:
Gender:F
Credentials:LICENSED MIDWIFE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4100 DUVAL RD
Mailing Address - Street 2:BLDG 2 SUITE 101
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759
Mailing Address - Country:US
Mailing Address - Phone:512-346-3224
Mailing Address - Fax:512-345-6637
Practice Address - Street 1:4100 DUVAL RD
Practice Address - Street 2:BLDG 2 SUITE 101
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759
Practice Address - Country:US
Practice Address - Phone:512-346-3224
Practice Address - Fax:512-345-6637
Is Sole Proprietor?:No
Enumeration Date:2011-06-24
Last Update Date:2011-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX99127176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife