Individual
RALEIGH R GLEASON III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1201 FAIRMOUNT AVE, FORT WORTH, TX 76104-4215
(817) 335-5288
(817) 338-0927
Mailing address
601 OMEGA DR STE 208, ARLINGTON, TX 76014-2075
(817) 465-5881
(817) 465-6336
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
H0387
TX
207RP1001X
Pulmonary Disease Physician
Primary
H0387
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
127732904
—
TX
Enumeration date
09/09/2005
Last updated
07/25/2023
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