Individual
LESLIE A FAWBUSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RNFA
Contact information
Practice address
2001 N JEFFERSON AVE, MOUNT PLEASANT, TX 75455-2338
(903) 577-6000
Mailing address
PO BOX 2626, FORT WORTH, TX 76113-2626
(817) 294-7444
(817) 294-7172
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
697217
TX
Other
Enumeration date
10/24/2011
Last updated
10/24/2011
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