Individual
LESLIE G BAGBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
1430 COLLIER ST, AUSTIN, TX 78704-2911
(512) 680-0440
Mailing address
1430 COLLIER ST, AUSTIN, TX 78704-2911
(512) 680-0440
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
00880
TX
Other
Enumeration date
04/03/2018
Last updated
01/17/2019
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