Provider Demographics
NPI:1114023538
Name:MCLEOD, JANIS MARIE (DDS)
Entity Type:Individual
Prefix:MRS
First Name:JANIS
Middle Name:MARIE
Last Name:MCLEOD
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5050 FM1960 W
Mailing Address - Street 2:SUITE 126
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77069
Mailing Address - Country:US
Mailing Address - Phone:281-440-0814
Mailing Address - Fax:713-455-5529
Practice Address - Street 1:5050 FM1960 W
Practice Address - Street 2:SUITE 126
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77069
Practice Address - Country:US
Practice Address - Phone:281-440-0814
Practice Address - Fax:713-455-5529
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15255122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist