Individual
MRS. LESLIE MARIE PHILLIPS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
10017 STONELEIGH DR, FORT WORTH, TX 76126
(817) 800-8386
(817) 295-4992
Mailing address
PO BOX 26617, FORT WORTH, TX 76126-9998
(817) 800-8386
(817) 295-4992
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
232148
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0079KE
BCBS OF TEXAS PROVIDER #
TX
Enumeration date
04/06/2006
Last updated
07/08/2007
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