Provider Demographics
NPI:1215251293
Name:MOCK, LEA MARIE (CD(DONA))
Entity type:Individual
Prefix:
First Name:LEA
Middle Name:MARIE
Last Name:MOCK
Suffix:
Gender:F
Credentials:CD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26755 BAYOU TESCH DR
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:TX
Mailing Address - Zip Code:77354-2818
Mailing Address - Country:US
Mailing Address - Phone:512-791-2198
Mailing Address - Fax:
Practice Address - Street 1:26755 BAYOU TESCH DR
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:TX
Practice Address - Zip Code:77354-2818
Practice Address - Country:US
Practice Address - Phone:512-791-2198
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-20
Last Update Date:2010-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula