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Individual

LESLIE C HARDICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
1325 PENNSYLVANIA AVE STE 690, FORT WORTH, TX 76104
(817) 924-2216
(817) 924-5602
Mailing address
1325 PENNSYLVANIA AVE STE 690, FORT WORTH, TX 76104-2133
(817) 924-2216
(817) 924-5602

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
L8362
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
185805202
TX
01
8BG630
BCBS
TX
Enumeration date
07/28/2006
Last updated
04/01/2019
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