1699319012 NPI number — JAMES-LEACH, INC.

Table of content: (NPI 1699319012)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699319012 NPI number — JAMES-LEACH, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JAMES-LEACH, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
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:
1699319012
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/16/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2004 S US HIGHWAY 77
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LA GRANGE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78945-6127
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
799-688-8209
Provider Business Mailing Address Fax Number:
979-968-6598

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
124 MEADOW LN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LA GRANGE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78945-1409
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
979-968-8820
Provider Business Practice Location Address Fax Number:
979-968-6598
Provider Enumeration Date:
10/29/2019

Additional Information

Authorized Official

Authorized Official Last Name:
GRAY
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
K
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
979-968-8820

Provider Taxonomy Codes

  • Taxonomy code: 320900000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com