1568989895 NPI number — DR. HANNAH GRACE LEININGER DPT

Table of content: DR. HANNAH GRACE LEININGER DPT (NPI 1568989895)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568989895 NPI number — DR. HANNAH GRACE LEININGER DPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LEININGER
Provider First Name:
HANNAH
Provider Middle Name:
GRACE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DPT
Provider Gender Code:
F

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:
1568989895
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/18/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
305 NE LOOP 820; BUSINESS TOWER 1
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
HURST
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76053
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
817-292-8787
Provider Business Mailing Address Fax Number:
817-789-6849

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
801 E 10TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EUDORA
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66025-8327
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-542-4940
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/28/2017

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: 225100000X , with the licence number:  1311669 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X , with the licence number: T-04844 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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