Individual
DR. LIESEL E.A. LEEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6606 LBJ FWY STE 200, DALLAS, TX 75240-6524
(972) 715-5000
(972) 715-9976
Mailing address
PO BOX 840853, DALLAS, TX 75284-5151
(972) 233-1999
(072) 233-3666
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
J4308
TX
207LP2900X
Pain Medicine (Anesthesiology) Physician
J3408
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0052NA
BC/BS
TX
05
—
125268606
—
TX
Enumeration date
02/23/2006
Last updated
03/24/2022
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