Individual
LESLIE D BEALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
1129 6TH AVE, FORT WORTH, TX 76104-4306
(682) 885-6248
(682) 885-6249
Mailing address
PO BOX 733784, DALLAS, TX 75373-3784
(682) 885-1855
(682) 885-1396
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
658280
TX
Other
Enumeration date
06/18/2007
Last updated
04/14/2021
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