Provider Demographics
NPI:1568090942
Name:LEBRASSEUR, KRISTIN ROSE (DO)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:ROSE
Last Name:LEBRASSEUR
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3501 N MACARTHUR BLVD STE 500
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75062-3675
Mailing Address - Country:US
Mailing Address - Phone:972-256-3700
Mailing Address - Fax:866-630-6348
Practice Address - Street 1:3501 N MACARTHUR BLVD STE 500
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-3675
Practice Address - Country:US
Practice Address - Phone:972-256-3700
Practice Address - Fax:866-630-6348
Is Sole Proprietor?:No
Enumeration Date:2020-03-31
Last Update Date:2024-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXU9584207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology