Provider Demographics
NPI:1285637827
Name:ROSENTHAL, LEON D (MD)
Entity Type:Individual
Prefix:
First Name:LEON
Middle Name:D
Last Name:ROSENTHAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5477 GLEN LAKES DR
Mailing Address - Street 2:STE 100
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-0946
Mailing Address - Country:US
Mailing Address - Phone:214-750-7776
Mailing Address - Fax:
Practice Address - Street 1:5477 GLEN LAKES DR
Practice Address - Street 2:STE 100
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-0946
Practice Address - Country:US
Practice Address - Phone:214-750-7776
Practice Address - Fax:214-750-4621
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXH07762084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8254B0Medicare PIN
F10744Medicare UPIN