Provider Demographics
NPI:1386117513
Name:LEO ALTENBERG MD PLLC
Entity type:Organization
Organization Name:LEO ALTENBERG MD PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEO
Authorized Official - Middle Name:LAWRENCE
Authorized Official - Last Name:ALTENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:915-271-8400
Mailing Address - Street 1:125 W HAGUE RD
Mailing Address - Street 2:STE 110
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-5804
Mailing Address - Country:US
Mailing Address - Phone:915-271-8400
Mailing Address - Fax:915-300-0115
Practice Address - Street 1:125 W HAGUE RD
Practice Address - Street 2:STE 110
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-5804
Practice Address - Country:US
Practice Address - Phone:915-271-8400
Practice Address - Fax:915-300-0115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-10
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty