Healthcare Provider Details

I. General information

NPI: 1306004684
Provider Name (Legal Business Name): ASHLEIGH MCCLENDON D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2008
Last Update Date: 08/25/2024
Certification Date: 08/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4400 LONG PRAIRIE RD
FLOWER MOUND TX
75028-1892
US

IV. Provider business mailing address

1121 E SPRING CREEK PKWY. STE. 110, #319
PLANO TX
75074
US

V. Phone/Fax

Practice location:
  • Phone: 214-343-6663
  • Fax: 214-343-2814
Mailing address:
  • Phone: 214-343-6663
  • Fax: 214-343-2814

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberOT-011557
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number0102203417
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberR7273
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: