Provider Demographics
NPI:1285886325
Name:LESLIE C COHAN MD PA
Entity type:Organization
Organization Name:LESLIE C COHAN MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:C
Authorized Official - Last Name:COHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD PA
Authorized Official - Phone:713-795-0349
Mailing Address - Street 1:7580 FANNIN ST
Mailing Address - Street 2:SUITE #235
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-1900
Mailing Address - Country:US
Mailing Address - Phone:713-795-0349
Mailing Address - Fax:713-795-4822
Practice Address - Street 1:7580 FANNIN ST
Practice Address - Street 2:SUITE #235
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-1900
Practice Address - Country:US
Practice Address - Phone:713-795-0349
Practice Address - Fax:713-795-4822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG2931174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXOODK38Medicare UPIN