Provider Demographics
NPI:1609801745
Name:COMESS, LEONARD J (MD)
Entity Type:Individual
Prefix:
First Name:LEONARD
Middle Name:J
Last Name:COMESS
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 1:7436 KENSHIRE LN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-2408
Mailing Address - Country:US
Mailing Address - Phone:214-728-1113
Mailing Address - Fax:817-284-9859
Practice Address - Street 1:1010 EMERALD ISLE DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75218-3980
Practice Address - Country:US
Practice Address - Phone:214-728-1113
Practice Address - Fax:817-284-9859
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2011-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD6242207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX116499801Medicaid
B21946Medicare UPIN
TXTXB124846Medicare PIN
TX116499801Medicaid