Provider Demographics
NPI:1427101344
Name:BARBOSA, LEYKA M (MD)
Entity type:Individual
Prefix:DR
First Name:LEYKA
Middle Name:M
Last Name:BARBOSA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LEYKA
Other - Middle Name:MEDILIA
Other - Last Name:BARBOSA DAVILA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:7777 FOREST LANE
Mailing Address - Street 2:SUITE C-610
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-2548
Mailing Address - Country:US
Mailing Address - Phone:972-566-2234
Mailing Address - Fax:972-566-6611
Practice Address - Street 1:7777 FOREST LANE
Practice Address - Street 2:SUITE C-610
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2548
Practice Address - Country:US
Practice Address - Phone:972-566-2234
Practice Address - Fax:972-566-6611
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ6868207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1160541-02Medicaid
TX752787826OtherTAX IDENTIFICATION NUMBER
TX0002EMOtherBCBS OF TEXAS, PROV. NO.
TX89490YOtherBCBS OF TX PERF PRV
TX752787826OtherTAX IDENTIFICATION NUMBER
TX00T97CMedicare PIN
TX8K9835Medicare PIN