Provider Demographics
NPI:1942340674
Name:MCBRIDE, LEONARD STANLEY (DDS)
Entity Type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:STANLEY
Last Name:MCBRIDE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15201 EAST FWY
Mailing Address - Street 2:ST 225
Mailing Address - City:CHANNELVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:77530-4131
Mailing Address - Country:US
Mailing Address - Phone:281-457-2847
Mailing Address - Fax:281-457-3191
Practice Address - Street 1:15201 EAST FWY
Practice Address - Street 2:ST 225
Practice Address - City:CHANNELVIEW
Practice Address - State:TX
Practice Address - Zip Code:77530-4131
Practice Address - Country:US
Practice Address - Phone:281-457-2847
Practice Address - Fax:281-457-3191
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX102131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice