Derdeyn, Leslie John

Derdeyn, Leslie John is an individual health care provider with primary practice located at 13737 Noel Rd Ste 1600 Attn Rays, Dallas TX 75240-1374. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Derdeyn, Leslie John can be contacted via phone (303) 933-8270.

Contact Information

Primary practice address
13737 Noel Rd Ste 1600 Attn Rays Dallas TX 75240-1374
Phone: (303) 933-8270
Fax: (303) 933-8270
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X F3900 Texas

Profile Details

NPI number 1831198209
LBN Legal business name Derdeyn, Leslie John
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 19th, 2005
Last updated May 31st, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1831198209 NPPES
Texas MEDICAID 132261203

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