Individual
DR. LESLIE D REDDELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O,
Contact information
Practice address
800 8TH AVE STE 306, FORT WORTH, TX 76104-2602
(822) 243-7486
(682) 841-0039
Mailing address
PO BOX 865, FORT WORTH, TX 76101-0865
(817) 632-1900
(817) 632-1904
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
P0783
TX
2086S0127X
Trauma Surgery Physician
Primary
P0783
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P0783
TEXAS
TX
Enumeration date
09/08/2011
Last updated
07/08/2025
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