Provider Demographics
NPI:1700063278
Name:LEBLANC, PAUL RENE (ANP-BC)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:RENE
Last Name:LEBLANC
Suffix:
Gender:M
Credentials:ANP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12121 RICHMOND AVE STE 215
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-2422
Mailing Address - Country:US
Mailing Address - Phone:713-997-3015
Mailing Address - Fax:
Practice Address - Street 1:12121 RICHMOND AVE STE 215
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-2422
Practice Address - Country:US
Practice Address - Phone:713-997-3015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-28
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP04809363LA2200X, 363LX0106X
TXAP121818363LX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational Health
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health