Active NPI
Leroy Anthony Bates IV, MS,LAT,ATC
- Athletic Trainer
- El Paso, TX
National Provider Identifier
1316469463
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT6734
- Practice address
- 12464 Tierra Encino Dr
El Paso, TX 79938-4524 - Phone
- (915) 490-1387
- NPI assigned
- Jul 11, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT6734 | TX | Primary |
Addresses
Primary practice location
12464 Tierra Encino Dr
El Paso, TX 79938-4524
Mailing address
12464 Tierra Encino Dr
El Paso, TX 79938-4524
Phone (915) 490-1387
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT6734 | TX | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1499731200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1316469463",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12464 TIERRA ENCINO DR",
"city": "EL PASO",
"state": "TX",
"postal_code": "799384524",
"telephone_number": "915-490-1387"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12464 TIERRA ENCINO DR",
"city": "EL PASO",
"state": "TX",
"postal_code": "799384524",
"telephone_number": "915-490-1387"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BATES",
"first_name": "LEROY",
"middle_name": "ANTHONY",
"name_prefix": "Mr.",
"name_suffix": "IV",
"credential": "MS,LAT,ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-07-11",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "TX",
"license": "AT6734",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in El Paso, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.