Provider Demographics
NPI:1992741615
Name:MORRISON, LEON MACMILLAN JR (MD)
Entity type:Individual
Prefix:DR
First Name:LEON
Middle Name:MACMILLAN
Last Name:MORRISON
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11607 GALLANT RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-6834
Mailing Address - Country:US
Mailing Address - Phone:281-759-5375
Mailing Address - Fax:
Practice Address - Street 1:15775 PARK TEN PL
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-5153
Practice Address - Country:US
Practice Address - Phone:281-647-2320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK4751174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
G95532Medicare UPIN
TX8A0749Medicare ID - Type Unspecified