Provider Demographics
NPI:1386028157
Name:DADA, LEANNE (DO)
Entity type:Individual
Prefix:
First Name:LEANNE
Middle Name:
Last Name:DADA
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4101 LOMO ALTO DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-1516
Mailing Address - Country:US
Mailing Address - Phone:469-868-6830
Mailing Address - Fax:469-868-6831
Practice Address - Street 1:4101 LOMO ALTO DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219-1516
Practice Address - Country:US
Practice Address - Phone:469-868-6830
Practice Address - Fax:469-868-6831
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-12
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS6379207RR0500X
FLUO4438207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology