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General NPI Number Information
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NPI Number | 1528399011
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Entity Type | Individual
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Provider Name | LESLEY ANNE HARCAR PAC
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Gender | Female
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Dates
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Enumeration Date | 01/22/2010
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Last Update Date | 08/04/2017
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Provider Practice Location Address
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Address Line | 2321 IRA E WOODS AVE #180
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City | GRAPEVINE
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State | TX
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Zip | 76051-8632
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Country | US
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Telephone | 817-329-2263
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Fax | 817-329-3793
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Provider Business Mailing Address
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Address Line | 2321 IRA E WOODS SUITE 180
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City | GRAPEVINE
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State | TX
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Zip | 76051
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Country | US
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Telephone | 817-329-2263
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Fax | 817-329-3793
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA06575
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License Number State | TX
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