Physician Compare National (NPI:1659500973)

HEALTHCARE PROVIDER: LESLEY RAMOS PARK M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1659500973
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4688729965
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20130323000021
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	PARK
	Individual professional last name
Provider First Name	LESLEY
	Individual professional first name
Provider Middle Name	A
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF TEXAS MEDICAL SCHOOL AT HOUSTON
	Individual professional's medical school
Graduation Year	2012
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	BAYLOR ST LUKES MEDICAL GROUP
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	9133213192
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	175
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	6624 FANNIN ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 1240
	Group Practice or individual's line 2 address
City	HOUSTON
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	770302324
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8323553575
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	670053
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	CHI ST LUKES HEALTH - SUGAR LAND HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y