Individual
DR. JEDIDIAH C LEAF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12221 MERIT DR, DALLAS, TX 75251-2202
(214) 217-1914
Mailing address
4121 GLENBROOK DR, RICHARDSON, TX 75082-3665
(337) 296-9666
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
MD203840
LA
207P00000X
Emergency Medicine Physician
Primary
P3643
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
303479501
—
TX
05
—
303479502
—
TX
01
—
P01075810
RAILROAD
TX
Enumeration date
06/10/2008
Last updated
03/07/2013
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