Individual
TIMOTHY LEISHMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
12924 WILLOW CHASE DR, HOUSTON, TX 77070-5641
(832) 905-9394
Mailing address
PO BOX 690925, HOUSTON, TX 77269-0925
(214) 399-5839
Taxonomy
Speciality
Code
Description
License number
State
1223D0004X
Dental Anesthesiology
Primary
38120
TX
1223G0001X
General Practice Dentistry
38120
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/13/2019
Last updated
07/06/2022
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