Provider Demographics
NPI:1356598304
Name:LEONARDSON, JANE ELISABETH (MD)
Entity type:Individual
Prefix:DR
First Name:JANE
Middle Name:ELISABETH
Last Name:LEONARDSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JANE
Other - Middle Name:MURRAY
Other - Last Name:MOULTRIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:200 RIVER POINTE SUITE 200
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304
Mailing Address - Country:US
Mailing Address - Phone:281-543-5263
Mailing Address - Fax:
Practice Address - Street 1:200 RIVER POINTE DR
Practice Address - Street 2:SUITE 200
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-2814
Practice Address - Country:US
Practice Address - Phone:281-543-5263
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-21
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ8069207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine