Individual
LESLIE P BUMPAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNTP
Contact information
Practice address
5002 HORSESHOE TRL, DALLAS, TX 75209-3324
(214) 360-0600
Mailing address
5002 HORSESHOE TRL, DALLAS, TX 75209-3324
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00001486
NUTRITIONAL THERAPY ASSOCIATION
WA
Enumeration date
04/12/2021
Last updated
04/12/2021
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