GEORGE FREDERICK LEATHERMAN (NPI# 1639289119) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639289119 |
| Entity Type | Individual |
| Full Name | GEORGE FREDERICK LEATHERMAN |
| Credential | M.D. |
| Practice Address |
709 Hollybrook Dr Suite 2301 Longview TX 75605-2411 |
| Mailing Address |
Po Box 19036 Belfast ME 04915-4085 |
| Practice Telephone | 9037575804 |
| Practice Fax Number | 9032322889 |
| Mailing Telephone | 9033817272 |
| Mailing Fax Number | 9033817269 |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2020-05-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
F6866 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 037408403 | 05 |
| Street Address |
709 HOLLYBROOK DR SUITE 2301 |
| City | LONGVIEW |
| State | TX |
| Zip Code | 75605-2411 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992781090 | Sanford Watkins | Emergency Medicine | 709 Hollybrook Dr, Suite 4500, Longview, TX 75605-2411 | 2005-12-20 |
| 1225550932 | Larry Fulton Holman Jr. | Nurse Practitioner | 709 Hollybrook Dr, Longview, TX 75605-2411 | 2017-07-13 |
| 1184159055 | Ryan M Guillory Md Pa | Pediatrics | 709 Hollybrook Dr, Suite 5605, Longview, TX 75605-2411 | 2017-04-27 |
| 1447524558 | Sau Chi Goretti Lau | Pharmacist | 709 Hollybrook Dr, Suite 100, Longview, TX 75605-2411 | 2012-03-07 |
| 1891095717 | Kristy Loftin-moening | Audiologist | 709 Hollybrook Dr, Suite 5601, Longview, TX 75605-2411 | 2010-10-26 |
| 1093973661 | Jorge Eduardo Massare-rodriguez | Specialist | 709 Hollybrook Dr, Suite 2301, Longview, TX 75605-2411 | 2008-05-29 |
| 1235333808 | Jonathan David Greifenkamp | Internal Medicine | 709 Hollybrook Dr, Suite 2301, Longview, TX 75605-2411 | 2007-06-14 |
| 1407050008 | Kathleen Weindorff Harris | Internal Medicine | 709 Hollybrook Dr, Suite 4500, Longview, TX 75605 | 2007-06-14 |
| 1366646564 | Action Medsource LLC. | Durable Medical Equipment & Medical Supplies | 709 Hollybrook Dr, Suite 3401, Longview, TX 75605-2411 | 2007-06-12 |
| 1447451406 | Diagnostic Clinic of Longview Pharmacy | Pharmacist | 709 Hollybrook Dr, Suite 4500, Longview, TX 75605-2411 | 2007-05-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194353730 | Dusty Rae Hane | Nurse Practitioner | Diagnostic Clinic of Longview, 2901 N Fourth St, Longview, TX 75605 | 2020-03-30 |
| 1831720374 | Kaycee Whatley | Nurse Practitioner | 323 W Hawkins Parkway, Longview, TX 75605 | 2020-02-03 |
| 1245733492 | Somers Pediatrics | Pediatrics | 103 W. Loop 281, Suite 474, Longview, TX 75605 | 2018-03-14 |
| 1467838391 | Piney Woods Er II LLC | Clinic/Center | 120 East Loop 281, Longview, TX 75605 | 2015-08-03 |
| 1386023968 | Elizabeth Ann Heeb Tidwell | Obstetrics & Gynecology | 802 Medical Dr Ste 100, Longview, TX 75605 | 2015-05-28 |
| 1215353651 | Tracy Hicks | Nurse Practitioner | 102 Commander Dr Ste 9, Longview, TX 75605 | 2014-03-10 |
| 1073881280 | Deirdre Scotter | Specialist/Technologist | 201 E Tomlinson Pkwy, Longview, TX 75605 | 2011-12-02 |
| 1316230139 | Traditions Hospice of Longview, LLC | Hospice Care, Community Based | 4362 N Us Hwy 259, Suite B, Longview, TX 75605 | 2011-05-26 |
| 1184916769 | Telema Dikibujiri Nga | Pediatrics | Longview Regional Medical Center, 2901 North Fourth Street, Longview, TX 75605 | 2011-05-13 |
| 1902101108 | The Veta Lewis Behavioral Health Group | Counselor | 1800 S. Judson St., Suite 100, Longview, TX 75605 | 2011-01-19 |
| Find all providers in zip 75605 | ||||
| Taxonomy Code | 207RI0011X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Interventional Cardiology |
| An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932219326 | Longview Cardiology Clinic, Pa | Internal Medicine | 402 N 7th St, Longview, TX 75601-6704 | 2006-08-30 |
| 1669739942 | Karthik Diwakar Mekala | Internal Medicine | 700 E Marshall Ave, Longview, TX 75601 | 2012-04-11 |
| 1083724520 | Rodney Lee Henry | Internal Medicine | 709 Hollybrook Dr, Suite 2301, Longview, TX 75605-2411 | 2006-08-30 |
| 1922118470 | Ronald Allen Scott | Internal Medicine | 709 Hollybrook Dr, Suite 2301, Longview, TX 75605-2411 | 2006-08-30 |
| 1326158890 | Krishna Reddy Nayini | Internal Medicine | 709 Hollybrook Dr, Suite 2301, Longview, TX 75605-2411 | 2006-08-30 |
| 1861502304 | Charles Floyd Newkirk | Internal Medicine | 709 Hollybrook Dr, Suite 2301, Longview, TX 75605-2411 | 2006-08-30 |
| 1609986165 | Charles Prentice Crumpler | Internal Medicine | 709 Hollybrook Dr, Suite 2301, Longview, TX 75605-2411 | 2006-08-30 |
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| 1104329440 | Deerbrook Cath Lab LLC | Internal Medicine | 18450 Hwy 59 Suite 101, Humble, TX 77338 | 2018-03-13 |
| 1073015681 | Dfw Heart and Wellness Center, Pllc | Internal Medicine | 425 N Highland Ave Ste 220, Sherman, TX 75092-7383 | 2018-02-28 |
| 1346758695 | Cardiac Cin of North Texas | Internal Medicine | 6565 N Macarthur Blvd Ste 225c, Irving, TX 75039-2490 | 2018-01-19 |
| 1487162368 | Cardiac Cin of West Texas LLC | Internal Medicine | 18911c Hardy Oak Blvd, San Antonio, TX 78258-4966 | 2018-01-13 |
| 1114435096 | Cardiac Cin of Austin LLC | Internal Medicine | 401 Congress Ave Ste 1540c, Austin, TX 78701-4071 | 2018-01-13 |
| 1275040925 | Prime Heart and Vascular, Pllc | Internal Medicine | 2633 Dallas Pkwy Ste 100, Plano, TX 75093-4715 | 2018-01-03 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.