MEDICARE: LEIGH TELZROW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	121766	TX

General Provider Information

NPI Number	:	1063095776
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEIGH TELZROW

Provider Business Mailing Address
First Line	:	9541 TARLETON ST
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75218-2757
Country	:	US
Telephone Number	:	214-546-0882
Fax Number	:

Provider Business Practice Location Address
First Line	:	9541 TARLETON ST
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75218-2757
Country	:	US
Telephone Number	:	214-546-0882
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/30/2021
Last Update Date	:	04/30/2021

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Directions to “ LEIGH TELZROW ” Practice Location

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