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General NPI Number Information
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NPI Number | 1144522368
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Entity Type | Individual
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Provider Name | LESLIE B. MILLS OT
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Gender | Female
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Dates
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Enumeration Date | 11/19/2010
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Last Update Date | 11/19/2010
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Provider Practice Location Address
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Address Line | 12001 LONGHORN PKWY
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City | AUSTIN
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State | TX
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Zip | 78732-1204
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Country | US
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Telephone | 512-358-6880
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Fax | 512-358-6880
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Provider Business Mailing Address
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Address Line | 245 COUNTY ROAD 2651
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City | RIO MEDINA
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State | TX
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Zip | 78066-2547
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Country | US
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Telephone | 210-854-6033
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Fax | 830-751-2905
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 105068
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License Number State | TX
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