Healthcare Provider Details

I. General information

NPI: 1265922264
Provider Name (Legal Business Name): DEVIN LESLIE DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2018
Last Update Date: 04/17/2023
Certification Date: 04/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

DELL SETON MEDICAL CENTER 1500 RED RIVER
AUSTIN TX
78701
US

IV. Provider business mailing address

DELL SETON MEDICAL CENTER 1500 RED RIVER
AUSTIN TX
78701
US

V. Phone/Fax

Practice location:
  • Phone: 512-324-8355
  • Fax:
Mailing address:
  • Phone: 512-324-8355
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberBP10065271
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberT8878
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: