Individual
JOHN R LEYENDECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5323 HARRY HINES BLVD, DALLAS, TX 75390-7201
(214) 648-7732
Mailing address
PO BOX 845347, DALLAS, TX 75284-5347
(214) 648-7732
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
L0377
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10080754
—
VA
01
—
1361K
BCBS
NC
05
—
3810000631
—
WV
01
—
7801123
AETNA
—
01
—
804390
PARTNERS
NC
05
—
891361K
—
NC
01
—
D5072
MEDCOST
NC
05
—
Q0054J
—
SC
Enumeration date
12/05/2005
Last updated
01/27/2015
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