Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | HO551 | TX |
Y | 207YS0123X | Facial Plastic Surgeon | HO551 | TX |
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | HO551 | TX |
NPI | 1114986627 |
---|---|
Provider Name | Dr. Joseph Lee Leach |
First Address | Dallas, TX 75284-5347 |
Second Address | Dallas, TX 75390-7208 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2006 |
Last Update Date | 10/01/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E83475 | (02) | TX |