Provider Demographics
NPI:1558476820
Name:LEVENTHAL, MILTON (MD)
Entity Type:Individual
Prefix:DR
First Name:MILTON
Middle Name:
Last Name:LEVENTHAL
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 1:5200 KELLER SPRINGS RD
Mailing Address - Street 2:1314
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-2723
Mailing Address - Country:US
Mailing Address - Phone:972-960-6598
Mailing Address - Fax:
Practice Address - Street 1:5200 KELLER SPRINGS RD
Practice Address - Street 2:1314
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75248-2723
Practice Address - Country:US
Practice Address - Phone:972-960-6598
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXC6409208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery