Provider Demographics
NPI:1649066366
Name:LEROY, BRODIE MICHAEL (DC)
Entity type:Individual
Prefix:DR
First Name:BRODIE
Middle Name:MICHAEL
Last Name:LEROY
Suffix:
Gender:
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3336 CROSS BEND RD
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75023-5700
Mailing Address - Country:US
Mailing Address - Phone:337-703-2401
Mailing Address - Fax:
Practice Address - Street 1:5100 BELT LINE RD STE 1012
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75254-7031
Practice Address - Country:US
Practice Address - Phone:214-854-3334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-18
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16157111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor