Provider Demographics
NPI:1689837064
Name:MCLEOD, MARIAM JENEEN (DC)
Entity Type:Individual
Prefix:DR
First Name:MARIAM
Middle Name:JENEEN
Last Name:MCLEOD
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2488 MEADOWGLEN DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-6541
Mailing Address - Country:US
Mailing Address - Phone:972-456-3888
Mailing Address - Fax:972-459-7038
Practice Address - Street 1:2488 MEADOWGLEN DR
Practice Address - Street 2:SUITE 201
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-6541
Practice Address - Country:US
Practice Address - Phone:972-456-3888
Practice Address - Fax:972-459-7038
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-07
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX10916111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor