Provider Demographics
NPI:1912467937
Name:LEO MEDICAL CONSULTING GROUP
Entity Type:Organization
Organization Name:LEO MEDICAL CONSULTING GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SHERMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NAGLER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:713-529-1010
Mailing Address - Street 1:1200 BINZ ST STE 1275B
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-6900
Mailing Address - Country:US
Mailing Address - Phone:713-529-1010
Mailing Address - Fax:713-529-6454
Practice Address - Street 1:1200 BINZ ST STE 1275B
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-6900
Practice Address - Country:US
Practice Address - Phone:713-529-1010
Practice Address - Fax:713-529-6454
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-25
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4303065OtherOTHER