Individual provider Active NPI

Dwayne Leach

  • Hearing Instrument Specialist
  • Longview, TX
National Provider Identifier
1871950642
Registry record updated Jan 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing Instrument SpecialistTaxonomy code 237700000X
License
50653 Issued in TX
Practice address
1609 Judson Rd
Longview, TX 75601-3663
Phone
(903) 753-5329
Fax
(903) 753-6818
NPI assigned
Jan 25, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Instrument Specialist 237700000X 50653 TX Primary

Addresses

Primary practice location

1609 Judson Rd
Longview, TX 75601-3663

Mailing address

1609 Judson Rd
Longview, TX 75601-3663
Phone (903) 753-5329

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

State licenses

LicenseStateTypeSpecialty
50653TXMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1453680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453680000000",
    "number": "1871950642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1609 JUDSON RD",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756013663",
            "telephone_number": "903-753-5329",
            "fax_number": "903-753-6818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1609 JUDSON RD",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756013663",
            "telephone_number": "903-753-5329",
            "fax_number": "903-753-6818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEACH",
        "first_name": "DWAYNE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-25",
        "last_updated": "2016-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "TX",
            "license": "50653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2016; 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.