Provider Demographics
NPI:1508843905
Name:MOY, LELAND ERIC (MD)
Entity Type:Individual
Prefix:DR
First Name:LELAND
Middle Name:ERIC
Last Name:MOY
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:PO BOX 840853
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-0853
Mailing Address - Country:US
Mailing Address - Phone:972-233-1999
Mailing Address - Fax:972-233-3666
Practice Address - Street 1:12222 MERIT DR STE 600
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75251-3294
Practice Address - Country:US
Practice Address - Phone:972-715-5000
Practice Address - Fax:972-715-9976
Is Sole Proprietor?:No
Enumeration Date:2005-12-27
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH2626207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX128111507Medicaid
TX8EH624OtherBCBS TX
TX84706KOtherBCBS
TX050064839OtherRAILROAD MEDICARE
TX128111502Medicaid
TX128111508Medicaid
TX128111509Medicaid
TX128111506Medicaid
TX128111501Medicaid
TX128111508Medicaid
TX89107KMedicare PIN
TX84706KOtherBCBS
TXTXB110338Medicare PIN
TX8EH624OtherBCBS TX
TX050064839OtherRAILROAD MEDICARE