Healthcare Provider Details

I. General information

NPI: 1578573325
Provider Name (Legal Business Name): LESLEY ANN SCHMITZ DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7003 CHAD COLLEY BLVD
FORT SMITH AR
72916-3000
US

IV. Provider business mailing address

4545 BELLAIRE DR S
FORT WORTH TX
76109-1889
US

V. Phone/Fax

Practice location:
  • Phone: 479-431-3500
  • Fax:
Mailing address:
  • Phone: 817-735-2235
  • Fax: 817-735-2480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License NumberL7877
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License NumberE-10709
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: