Provider Demographics
NPI:1962629543
Name:KIBUULE, LEONARD K (MD)
Entity Type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:K
Last Name:KIBUULE
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 1:1900 NORTH LOOP W STE 670
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77018-8119
Mailing Address - Country:US
Mailing Address - Phone:281-673-4360
Mailing Address - Fax:281-868-7036
Practice Address - Street 1:1900 NORTH LOOP W STE 670
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77018-8119
Practice Address - Country:US
Practice Address - Phone:281-673-4360
Practice Address - Fax:281-868-7036
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN0166207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine