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NPI Code Detail

MEDICARE: DR. LESLIE EARLE TINGLE M.D.

MEDICARE: DR. LESLIE EARLE TINGLE M.D.
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
1207QG0300XGeriatric Medicine (Family Medicine) PhysicianE4721TX

General Provider Information

NPI Number : 1871552943
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LESLIE EARLE TINGLE M.D.
Provider Business Mailing Address
First Line : 105 MEDICAL PLZ
Second Line :
City : SULPHUR SPRINGS
State : TX
Zip : 75482-2136
Country : US
Telephone Number : 903-438-3336
Fax Number : 903-438-3385
Provider Business Practice Location Address
First Line : 105 MEDICAL PLZ
Second Line :
City : SULPHUR SPRINGS
State : TX
Zip : 75482-2136
Country : US
Telephone Number : 903-438-3336
Fax Number : 903-438-3385
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/18/2006
Last Update Date : 01/21/2016

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