MEDICARE: MRS. LESLIE ANN WILLIAMS NP

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	363L00000X	Nurse Practitioner	1227006	TX

General Provider Information

NPI Number	:	1578425229
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LESLIE ANN WILLIAMS NP

Provider Business Mailing Address
First Line	:	19203 COUNTY ROAD 2187 E
Second Line	:
City	:	TATUM
State	:	TX
Zip	:	75691-3762
Country	:	US
Telephone Number	:	214-906-2270
Fax Number	:

Provider Business Practice Location Address
First Line	:	4848 NE STALLINGS DR STE 201
Second Line	:
City	:	NACOGDOCHES
State	:	TX
Zip	:	75965-1266
Country	:	US
Telephone Number	:	936-221-5560
Fax Number	:	936-221-5710

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

Provider Enumeration Date	:	12/02/2025
Last Update Date	:	02/10/2026

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