Individual
FREDRICK SEBASTIAN LEACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7000 W PLANO PKWY STE 240, PLANO, TX 75093-1637
(972) 384-3470
(972) 384-3474
Mailing address
PO BOX 117285, CARROLLTON, TX 75011-7285
(972) 384-3470
(972) 384-3474
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
J9736
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
TXB103992
PTAN
TX
Enumeration date
05/08/2006
Last updated
04/10/2014
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