Provider Information for 1326144163
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Mr. GORDON SHAW LEITH LPC
Sex: Male
NPI: 1326144163
Last Updated: 2007-07-08
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1326144163 | ||||||||
| Enumeration Date | 2006-09-16 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 245 WEATHERCOCK LN SAN ANTONIO, TX 78239-1935 United States Phone: 210-590-9292 | Fax:210-568-4663 | ||||||||
| Primary Practice Address | 8930 FOURWINDS DR STE 218 SAN ANTONIO, TX 78239-1970 United States Phone: 210-590-9292 | Fax:210-568-4663 | ||||||||
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