Provider Demographics
NPI:1447588637
Name:SHEPPARD, LEONARD JR
Entity type:Individual
Prefix:MR
First Name:LEONARD
Middle Name:
Last Name:SHEPPARD
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 FM 1092 RD
Mailing Address - Street 2:#423
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-5421
Mailing Address - Country:US
Mailing Address - Phone:281-788-0898
Mailing Address - Fax:510-743-8259
Practice Address - Street 1:10802 MONTVERDE LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77099-4717
Practice Address - Country:US
Practice Address - Phone:281-788-0898
Practice Address - Fax:510-743-8259
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-26
Last Update Date:2009-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health