MEDICARE: MISS LESHA DAWN ROBERTS D.C.

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	111N00000X	Chiropractor	5259	TX

General Provider Information

NPI Number	:	1548242688
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS LESHA DAWN ROBERTS D.C.

Provider Business Mailing Address
First Line	:	1710 S DAIRY ASHFORD RD STE 109
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77077-3859
Country	:	US
Telephone Number	:	281-870-1233
Fax Number	:	281-870-1037

Provider Business Practice Location Address
First Line	:	1710 S DAIRY ASHFORD RD STE 109
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77077-3853
Country	:	US
Telephone Number	:	281-870-1233
Fax Number	:	281-870-1037

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

Provider Enumeration Date	:	11/15/2005
Last Update Date	:	10/10/2013

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