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Individual

DR. NATHAN EDWIN LESLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5612 EDWARDS RANCH RD, FORT WORTH, TX 76109-4145
(817) 420-9238
(817) 357-4363
Mailing address
PO BOX 961205, FORT WORTH, TX 76161-1205
(817) 877-3277
(817) 877-3280

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
N0921
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
285881301
TX
01
P01021883
RAILROAD MEDICARE
TX
Enumeration date
08/18/2009
Last updated
12/18/2020
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