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Individual

DR. KENNETH B. DEKLEVA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6363 FOREST PARK ROAD, SUITE 749, DALLAS, TX 75390-9121
(214) 645-8500
(214) 645-3775
Mailing address
PO BOX 845347, DALLAS, TX 75284-5347
(214) 645-0624
(214) 645-0078

Taxonomy

Speciality
Code
Description
License number
State
2084F0202X
Forensic Psychiatry Physician
H7993
TX
2084P0800X
Psychiatry Physician
Primary
H7993
TX

Other

Enumeration date
03/30/2007
Last updated
01/03/2019
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