Provider Demographics
NPI:1821275959
Name:JENG, LEO (MD)
Entity Type:Individual
Prefix:DR
First Name:LEO
Middle Name:
Last Name:JENG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4100 W 15TH ST STE 202
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5801
Mailing Address - Country:US
Mailing Address - Phone:972-943-5914
Mailing Address - Fax:972-943-5916
Practice Address - Street 1:4100 W 15TH ST STE 202
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5801
Practice Address - Country:US
Practice Address - Phone:972-943-5914
Practice Address - Fax:972-943-5916
Is Sole Proprietor?:No
Enumeration Date:2008-01-31
Last Update Date:2017-12-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXN8797207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXN8797OtherMEDICAL LICENSE
TXTXB132055Medicare PIN