Individual
AMBER MARIE LESLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5612 EDWARDS RANCH RD, FORT WORTH, TX 76109-4145
(817) 921-5446
(817) 377-6560
Mailing address
PO BOX 961205, FORT WORTH, TX 76161-1205
(817) 740-8400
(817) 921-5446
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
M8791
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
195049501
—
TX
01
—
P00643341
RAIL ROAD MEDICARE
TX
Enumeration date
05/22/2007
Last updated
12/18/2020
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