Provider Demographics
NPI:1720102445
Name:LEFFLER, JOEL NORMAN (MD)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:NORMAN
Last Name:LEFFLER
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 1:4112 W 15TH STREET
Mailing Address - Street 2:SUITE 201
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5858
Mailing Address - Country:US
Mailing Address - Phone:972-985-1233
Mailing Address - Fax:972-985-9939
Practice Address - Street 1:4112 W 15TH STREET
Practice Address - Street 2:SUITE 201
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5858
Practice Address - Country:US
Practice Address - Phone:972-985-1233
Practice Address - Fax:972-985-9939
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG8617207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00HS42Medicare ID - Type Unspecified
TXB24312Medicare UPIN