Provider Demographics
NPI:1265492391
Name:LEIDNER, RICHARD NEIL (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:NEIL
Last Name:LEIDNER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:13131 HUNTERS BRK
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-2074
Mailing Address - Country:US
Mailing Address - Phone:210-492-5954
Mailing Address - Fax:210-492-5954
Practice Address - Street 1:3851 ROGER BROOKE DRIVE
Practice Address - Street 2:
Practice Address - City:FORT SAM HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:78234-6200
Practice Address - Country:US
Practice Address - Phone:210-916-3710
Practice Address - Fax:210-916-5102
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXF82052084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology