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General NPI Number Information
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NPI Number | 1891703583
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Entity Type | Organization
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Legal Business Name | NANCY LESLIE PHD & ASSOCIATES IN MEDICAL PSYCHOLOGY, PC
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Dates
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Enumeration Date | 08/04/2006
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Last Update Date | 02/12/2008
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Provider Practice Location Address
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Address Line | 3201 UNIVERSITY DR E SUITE 420
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City | BRYAN
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State | TX
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Zip | 77802-3475
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Country | US
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Telephone | 979-774-1000
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Fax | 979-776-1211
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Provider Business Mailing Address
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Address Line | 3201 UNIVERSITY DR E SUITE 420
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City | BRYAN
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State | TX
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Zip | 77802-3475
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Country | US
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Telephone | 979-774-1000
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Fax | 979-776-1211
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Authorized Official
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Title or Position | OWNER
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Name | NANCY ADAMS LESLIE
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Credential | PH.D.
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Telephone | 979-774-1000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number |
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License Number State |
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