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Contact Information

LARISSA LEATH
8207 JOE DIMAGGIO ST
SAN ANTONIO, TX78240-2923
 Phone: 210-387-9549
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Care

2279G1100X
Indicates primary specialty

NPI Profile & details for LARISSA LEATH · (Female)

NPI # 1992194674
Status Active
Credentials
Entity Individual
Enumeration date 01/17/2015
Last updated 01/17/2015 - About 11 years ago
Sole proprietor 1 No
Identifiers
  • TX License # 76030
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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