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Individual
DR. TED WILLIS LEDET
Active
Individual
DR. TED WILLIS LEDET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
G9144
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000GR74
BLUE CROSS
TX
01
—
123232401
TPI
TX
01
—
340001471
RR MEDICARE
TX
05
—
P000GR742
—
TX
Enumeration date
08/20/2006
Last updated
07/01/2010
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