Provider Demographics
NPI:1366476467
Name:FRID-HONIGSBLUM, LEON (MD)
Entity Type:Individual
Prefix:DR
First Name:LEON
Middle Name:
Last Name:FRID-HONIGSBLUM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6757 ARAPAHO RD
Mailing Address - Street 2:SUITE 711
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-4005
Mailing Address - Country:US
Mailing Address - Phone:972-488-8926
Mailing Address - Fax:972-881-4390
Practice Address - Street 1:6757 ARAPAHO RD
Practice Address - Street 2:STE 711 PMB 335
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75248-4005
Practice Address - Country:US
Practice Address - Phone:972-488-8926
Practice Address - Fax:972-881-4390
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH4922207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00G91WMedicare PIN
TX00459FMedicare PIN