Individual
LESLY PONCE BARRERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MCN, RD, LD
Contact information
Practice address
801 CONOVER DR, GRAND PRAIRIE, TX 75051-1519
(214) 266-3400
Mailing address
4008 ALTOONA DR APT 107, DALLAS, TX 75233-3516
(832) 893-7775
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT88635
TX
Other
Enumeration date
06/28/2023
Last updated
06/28/2023
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