1396847182 NPI number — ROBERT LEPOSAVIC M.D.

Table of content: ROBERT LEPOSAVIC M.D. (NPI 1396847182)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396847182 NPI number — ROBERT LEPOSAVIC M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LEPOSAVIC
Provider First Name:
ROBERT
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1396847182
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/12/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3827 N 10TH ST STE 305
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MCALLEN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78501-1745
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
568-030-7489
Provider Business Mailing Address Fax Number:
805-681-1768

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5333 HOLLISTER AVE STE 105
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SANTA BARBARA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93111-3309
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-770-8400
Provider Business Practice Location Address Fax Number:
805-770-8400
Provider Enumeration Date:
09/02/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207ND0101X , with the licence number:  A63047 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)