Individual
MR. DAVID LEDESMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
1071 COUNTRY CLUB RD, SUITE F, EL PASO, TX 79932-3173
(915) 592-0023
(915) 592-0023
Mailing address
1071 COUNTRY CLUB RD, SUITE F, EL PASO, TX 79932-3173
(915) 592-0023
(915) 592-0023
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
109211
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2587HM
BCBS PROVIDER #
TX
01
—
742846287
FEDERAL TAX I.D. #
TX
Enumeration date
03/26/2007
Last updated
08/29/2008
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