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Individual

LESLIE D JENNINGS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4323 N JOSEY LN, 307, CARROLLTON, TX 75010-4630
(972) 394-0118
(972) 394-1058
Mailing address
4323 N JOSEY LN, 307, CARROLLTON, TX 75010-4630
(972) 394-0118
(972) 394-1058

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
F9619
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4878330001
DMEPOS
TX
Enumeration date
11/11/2005
Last updated
04/20/2012
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