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General NPI Number Information
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NPI Number | 1699187005
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Entity Type | Individual
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Provider Name | LEEANN ANSICA NELSON M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/20/2014
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Last Update Date | 09/05/2024
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Provider Practice Location Address
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Address Line | 8585 N STEMMONS FWY STE 200S
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City | DALLAS
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State | TX
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Zip | 75247-3821
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Country | US
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Telephone | 214-424-5600
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Fax |
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Provider Business Mailing Address
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Address Line | 8585 N STEMMONS FWY STE 200S
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City | DALLAS
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State | TX
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Zip | 75247-3821
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Country | US
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Telephone | 214-424-5600
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Fax |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MMD.36842MD
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number | R6058
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number | ME136488
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License Number State | FL
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