Individual provider Active NPI

Gary Evan Leka, PH.D.

  • Clinical Psychologist
  • Edinburg, TX
National Provider Identifier
1134138589
Registry record updated Oct 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
31070 Issued in TX
Practice address
5109 S McColl Rd
Edinburg, TX 78539-7885
Phone
(956) 682-0385
Fax
(956) 682-0388
NPI assigned
Aug 5, 2006
Last updated
Oct 5, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 16196 TX
Clinical Psychologist 103TC0700X 31070 TX Primary

Addresses

Primary practice location

5109 S McColl Rd
Edinburg, TX 78539-7885

Mailing address

5109 S McColl Rd
Edinburg, TX 78539-7885
Phone (956) 682-0385

Other identifiers 1

IdentifierTypeStateIssuer
028551201MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170322001127 TX Practitioner - Clinical Psychologist 6709161391 Practice locations: Edinburg, TX

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
16196TXMDChiropractor
31070TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Psychological Services PC PastSince Jan 1, 2005 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475625600000",
    "number": "1134138589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5109 S MCCOLL RD",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785397885",
            "telephone_number": "956-682-0385",
            "fax_number": "956-682-0388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5109 S MCCOLL RD",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785397885",
            "telephone_number": "956-682-0385",
            "fax_number": "956-682-0388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEKA",
        "first_name": "GARY",
        "middle_name": "EVAN",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2016-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "16196",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "31070",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "028551201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edinburg, TX

Sources for this page

Verify at the official NPI Registry.