Provider Information for 1760196554
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ALEXANDER LEERBURGER-MAHL LPC, NCC
Sex: Male
NPI: 1760196554
Last Updated: 2023-01-06
Certification Date: 2023-01-05
Certification Date: 2023-01-05
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1760196554 | ||||||||
| Enumeration Date | 2023-01-06 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 8500 N MOPAC EXPY STE 601 AUSTIN, TX 78759-8347 United States Phone: 512-527-3275 | Fax: | ||||||||
| Primary Practice Address | 8500 N MOPAC EXPY STE 601 AUSTIN, TX 78759-8347 United States Phone: 512-527-3275 | Fax: | ||||||||
| Secondary Practice Address(es) | 4505 DUVAL ST APT 210 | ||||||||
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