Provider Demographics
NPI:1326119140
Name:KLEIMAN, LAURIE (MD)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:
Last Name:KLEIMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 N STEMMONS FWY
Mailing Address - Street 2:SUITE 151
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75207-2113
Mailing Address - Country:US
Mailing Address - Phone:888-905-0595
Mailing Address - Fax:214-905-0979
Practice Address - Street 1:2600 N STEMMONS FWY
Practice Address - Street 2:SUITE 151
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75207-2113
Practice Address - Country:US
Practice Address - Phone:888-905-0595
Practice Address - Fax:214-905-0979
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2016-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK20532084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH30502Medicare UPIN
TX00965QMedicare ID - Type Unspecified
TX00965QMedicare PIN