Individual
MRS. DORIS MARIE LEIST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
123 FM 1621, COMFORT, TX 78013
(210) 670-9030
Mailing address
PO BOX 781716, SAN ANTONIO, TX 78278-1716
(210) 670-9030
(210) 675-4072
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
G8898
TX
Other
Enumeration date
11/15/2005
Last updated
07/08/2007
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