Provider Demographics
NPI:1245088681
Name:FEZA, LEONARD
Entity type:Individual
Prefix:
First Name:LEONARD
Middle Name:
Last Name:FEZA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3820 VITRUVIAN WAY APT 328
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-4050
Mailing Address - Country:US
Mailing Address - Phone:469-478-0709
Mailing Address - Fax:
Practice Address - Street 1:3820 VITRUVIAN WAY APT 328
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001-4050
Practice Address - Country:US
Practice Address - Phone:469-478-0709
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-09
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver