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NPI Code Detail

MEDICARE: LESLIE H. SECREST M.D., PA

MEDICARE: LESLIE H. SECREST M.D., PA
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
12084P0800XPsychiatry PhysicianD5202TX

General Provider Information

NPI Number : 1437395472
Entity Type Code : Organization
Provider Name (Legal Business Name) : LESLIE H. SECREST M.D., PA
Provider Business Mailing Address
First Line : PO BOX 195783
Second Line :
City : DALLAS
State : TX
Zip : 75219-8613
Country : US
Telephone Number : 214-225-0848
Fax Number : 214-345-2682
Provider Business Practice Location Address
First Line : 8222 DOUGLAS AVE STE 604
Second Line :
City : DALLAS
State : TX
Zip : 75225-5937
Country : US
Telephone Number : 214-345-7355
Fax Number : 469-250-4802
Authorized Official
Title or Position : PSYCHATRIST
Name : DR. LESLIE H SECREST
Credential : M.D.
Telephone Number : 214-225-0848
Provider Enumeration Date : 12/22/2008
Last Update Date : 12/22/2021

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Directions to “LESLIE H. SECREST M.D., PA ” Practice Location

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