=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841478120
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LESLIE H HOUSTON NP-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/08/2008
-----------------------------------------------------
Last Update Date | 05/30/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 225 BANK FIRST DR
-----------------------------------------------------
City | FLOWOOD
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 39232-6611
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 601-992-0004
-----------------------------------------------------
Fax | 769-572-7926
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 225 BANK FIRST DR
-----------------------------------------------------
City | FLOWOOD
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 39232-6611
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 601-624-2398
-----------------------------------------------------
Fax | 769-572-7926
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | R867447
-----------------------------------------------------
License Number State | MS
-----------------------------------------------------