Individual
LESLE JO BREWER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CST
Contact information
Practice address
1040 S FLEISHEL AVE, TYLER, TX 75701-2031
(309) 533-8702
Mailing address
1525 S HIGHLAND AVE, TYLER, TX 75701-3200
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
151890
TX
246ZS0410X
Surgical Technologist
Primary
151890
TX
Other
Enumeration date
11/07/2018
Last updated
11/07/2018
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