Provider Demographics
NPI:1033318456
Name:DRS. LEIMAN AND SIMON, PA
Entity type:Organization
Organization Name:DRS. LEIMAN AND SIMON, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HERBERT
Authorized Official - Middle Name:I
Authorized Official - Last Name:LEIMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-821-0820
Mailing Address - Street 1:3600 GASTON AVE STE 705
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-1807
Mailing Address - Country:US
Mailing Address - Phone:214-821-0820
Mailing Address - Fax:214-826-8430
Practice Address - Street 1:3600 GASTON AVE STE 705
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-1807
Practice Address - Country:US
Practice Address - Phone:214-821-0820
Practice Address - Fax:214-826-8430
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-16
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE3453174400000X
TXD6066174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00AT38Medicare PIN