Individual
JAMES RAYMOND LEDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
855 MONTGOMERY, FORT WORTH, TX 76107-2553
(817) 735-2000
Mailing address
PO BOX 99335, FORT WORTH, TX 76199-0335
(817) 735-2000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA06845
TX
363AM0700X
Medical Physician Assistant
—
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
280634101
—
TX
01
—
844N83
BCBS
TX
Enumeration date
08/02/2010
Last updated
08/10/2011
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