Individual
LESLIE PAUL DULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.A.T.
Contact information
Practice address
2211 MCKINLEY AVE, FORT WORTH, TX 76164-7739
(817) 814-4086
Mailing address
2211 MCKINLEY AVE, FORT WORTH, TX 76164-7739
(817) 814-4086
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
2255A2300X
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AT1270
ADVISORY BOARD OF ATHLETIC TRAINERS
TX
Enumeration date
08/16/2016
Last updated
08/16/2016
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