Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | DO2046 | NV |
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | R3481 | TX |
NPI | 1528347234 |
---|---|
Provider Name | Leroy Butler |
First Address | Frisco, TX 75034-4063 |
Second Address | Frisco, TX 75034-4063 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2011 |
Last Update Date | 08/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1528347234 | (05) | NV |