Healthcare Provider Details

I. General information

NPI: 1174866461
Provider Name (Legal Business Name): LESLIE L ISAACS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LESLIE L LETSCHER RN

II. Dates (important events)

Enumeration Date: 04/04/2013
Last Update Date: 04/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9846 HWY 31 E
TYLER TX
75705-2329
US

IV. Provider business mailing address

202 RIDGECREST DR
JACKSONVILLE TX
75766-5711
US

V. Phone/Fax

Practice location:
  • Phone: 903-592-8001
  • Fax: 903-581-1879
Mailing address:
  • Phone: 877-696-8773
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number768774
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: