Healthcare Provider Details

I. General information

NPI: 1023754512
Provider Name (Legal Business Name): LESLIE STEPHANIE ABRAHAM FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LESLIE STEPHANIE GARZA

II. Dates (important events)

Enumeration Date: 05/09/2022
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17602 COUNTY ROAD 1810
LUBBOCK TX
79424-2151
US

IV. Provider business mailing address

17602 COUNTY ROAD 1810
LUBBOCK TX
79424-2151
US

V. Phone/Fax

Practice location:
  • Phone: 210-201-6334
  • Fax:
Mailing address:
  • Phone: 806-853-0936
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1076155
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: