MEDICARE: LESLIE HOWELL DO PC

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	2084P0800X	Psychiatry Physician	1195	NV

General Provider Information

NPI Number	:	1316120314
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LESLIE HOWELL DO PC

Provider Business Mailing Address
First Line	:	2920 N GREEN VALLEY PKWY
Second Line	:	BLDG 3 SUITE 312
City	:	HENDERSON
State	:	NV
Zip	:	89014-0406
Country	:	US
Telephone Number	:	702-253-1173
Fax Number	:

Provider Business Practice Location Address
First Line	:	2920 N GREEN VALLEY PKWY
Second Line	:	BLDG 3 SUITE 312
City	:	HENDERSON
State	:	NV
Zip	:	89014-0406
Country	:	US
Telephone Number	:	702-253-1173
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	LESLIE HOWELL
Credential	:	DO PC
Telephone Number	:	702-253-1173

Provider Enumeration Date	:	12/12/2007
Last Update Date	:	12/19/2007

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