Provider Demographics
NPI:1245264415
Name:KIBERT, LEONARD G (MD)
Entity type:Individual
Prefix:
First Name:LEONARD
Middle Name:G
Last Name:KIBERT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2117 CHENEVERT ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77003-5848
Mailing Address - Country:US
Mailing Address - Phone:713-654-7488
Mailing Address - Fax:713-654-7428
Practice Address - Street 1:2117 CHENEVERT ST
Practice Address - Street 2:SUITE A
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77003-5848
Practice Address - Country:US
Practice Address - Phone:713-654-7488
Practice Address - Fax:713-654-7428
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2007-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXJ2639207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB42031Medicare UPIN