Mary E Leafblad, ATC, LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT5474 Issued in TX

Practice address

14606 Dallas Pkwy Apt 1100
Dallas, TX 75254-7451

Phone

(715) 379-5838

NPI assigned

Sep 3, 2024

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1725321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1013742782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14606 DALLAS PKWY APT 1100",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752547451",
            "telephone_number": "715-379-5838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14606 DALLAS PKWY APT 1100",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752547451",
            "telephone_number": "715-379-5838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEAFBLAD",
        "first_name": "MARY",
        "middle_name": "E",
        "credential": "ATC, LAT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-03",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "AT5474",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL CERTIFICATION NUMBER",
            "identifier": "989154",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSURE",
            "identifier": "AT5474",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joseph Lee Leach, MD
• Michael James Leach, PHD
• Steven L Leach, MD
• Leadher Well LLC
• Jedidiah C Leaf, MD
• Harriet Leahy, MB BCH
• Matthew Leahy, PH.D.
• Will F Leake
• Maria del Pilar Leal Leyte, M.D.
• Amelia Leal-Serrata, FNP-BC

• Athletic Trainer in Dallas, TX
• Providers in Dallas, TX by specialty
• Athletic Trainer in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.