Individual
LESLIE HUMPHREY DEBONA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
13737 NOEL RD, STE 1400, DALLAS, TX 75240
(972) 715-5000
(972) 715-9976
Mailing address
PO BOX 840853, DALLAS, TX 75284-0853
(972) 233-1999
(972) 233-3666
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
635835
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002518102
—
TX
05
—
002518103
—
TX
05
—
002518104
—
TX
01
—
88754U
BCBS
TX
01
—
P00679481
RAILROAD
TX
Enumeration date
02/15/2007
Last updated
06/06/2018
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