Individual
DR. LEANN KRIDELBAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2750 W. NORTHWEST HWY, SUITE 170, DALLAS, TX 75220-4783
(214) 654-0007
(214) 654-9272
Mailing address
7547 GREENBRIER DR, DALLAS, TX 75225-4514
(214) 692-5361
(214) 456-6819
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
J8629
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
139112017
—
TX
05
—
139112019
—
TX
05
—
139112020
—
TX
05
—
139112021
—
TX
05
—
139112026
—
TX
01
—
176920001
TPI
TX
Enumeration date
09/13/2006
Last updated
08/03/2011
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