Individual
JIN-SHONE LEO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4005 24TH ST, LUBBOCK, TX 79410-1835
(806) 792-2767
(806) 791-6709
Mailing address
4005 24TH ST, LUBBOCK, TX 79410-1835
(806) 792-2767
(806) 791-6709
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
F2323
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
625862
FIRST HEALTH
—
01
—
87471Y
BLUE CROSS
TX
05
—
X4609
—
NM
Enumeration date
06/16/2005
Last updated
07/08/2007
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