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1265405534

NPI Code Detail

MEDICARE: DR. LESLIE JAMES ALLISON MD

MEDICARE: DR. LESLIE JAMES ALLISON MD

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	207Q00000X	Family Medicine Physician	J7408	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	01072872A	OTHER	IN	STATE LICENSE
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	4119831	OTHER	TX	BLUE LINK #
6	00U53H	OTHER		BLUE CROSS BLUE SHIELD
7	21643	OTHER	TX	UTMB
8	5272075	OTHER	TX	AETNA
9	429053	OTHER		WELLCARE
10	121372	OTHER	TX	SUPERIOR HEALTH

General Provider Information

NPI Number	:	1265405534
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LESLIE JAMES ALLISON MD

Provider Business Mailing Address
First Line	:	5080 SPECTRUM DR
Second Line	:	STE 1200W
City	:	ADDISON
State	:	TX
Zip	:	75001-4624
Country	:	US
Telephone Number	:	972-720-7820
Fax Number	:	214-775-4502

Provider Business Practice Location Address
First Line	:	6920 INDIANAPOLIS BLVD
Second Line	:
City	:	HAMMOND
State	:	IN
Zip	:	46324-2206
Country	:	US
Telephone Number	:	219-763-8112
Fax Number	:	219-764-3251

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

Provider Enumeration Date	:	02/08/2006
Last Update Date	:	03/11/2016

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Directions to “ DR. LESLIE JAMES ALLISON MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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