Provider Demographics
NPI:1730206426
Name:LANDSBERG, TODD
Entity type:Individual
Prefix:DR
First Name:TODD
Middle Name:
Last Name:LANDSBERG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:TODD
Other - Middle Name:
Other - Last Name:LANDSBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD CCC-A
Mailing Address - Street 1:PO BOX 844658
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-4658
Mailing Address - Country:US
Mailing Address - Phone:254-724-2111
Mailing Address - Fax:
Practice Address - Street 1:200 MEDICAL PKWY STE 120
Practice Address - Street 2:
Practice Address - City:LAKEWAY
Practice Address - State:TX
Practice Address - Zip Code:78738-1792
Practice Address - Country:US
Practice Address - Phone:512-654-1234
Practice Address - Fax:855-563-2794
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND7340231H00000X
TX81495231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist