| Leonard Berry Jr Llc | |
|
9455 S Lancaster Hutchins Rd Hutchins TX 75141-3368 | |
| (972) 225-0081 | |
| (972) 225-0805 |
| Full Name | Leonard Berry Jr Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 9455 S Lancaster Hutchins Rd, Hutchins, Texas |
| Authorized Official Name and Position | Leonard Autwood Berry (OWNER) |
| Authorized Official Contact | 9722250081 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Leonard Berry Jr Llc Po Box 860 Hutchins TX 75141-0860 Ph: (972) 225-0081 | Leonard Berry Jr Llc 9455 S Lancaster Hutchins Rd Hutchins TX 75141-3368 Ph: (972) 225-0081 |
| NPI Number | 1265693121 |
|---|---|
| Provider Enumeration Date | 06/23/2008 |
| Last Update Date | 01/13/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265693121 | NPI | - | NPPES |
| 139317516 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | H3620 (Texas) | Primary |