Individual
JESSICA SUZAHNE LEIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3601 4TH ST, LUBBOCK, TX 79430-3396
(806) 743-2373
Mailing address
3601 4TH ST # MS 8312, LUBBOCK, TX 79430-0002
(806) 743-1501
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085.003344
IL
363A00000X
Physician Assistant
Primary
PA06925
TX
Other
Enumeration date
11/18/2008
Last updated
12/06/2021
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