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1053554527

NPI Code Detail

MEDICARE: LESLEY B. CONRAD M.D.

MEDICARE: LESLEY B. CONRAD M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207VX0201X	Gynecologic Oncology Physician	69392	GA
2	207VX0201X	Gynecologic Oncology Physician	32914	NE
3	207VX0201X	Gynecologic Oncology Physician	P8232	TX
4	207V00000X	Obstetrics & Gynecology Physician	69392	GA
5	207V00000X	Obstetrics & Gynecology Physician	P8232	TX
6	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1053554527
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LESLEY B. CONRAD M.D.

Provider Business Mailing Address
First Line	:	7261 MERCY RD
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68124-2311
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6201 HARRY HINES BLVD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75390-9201
Country	:	US
Telephone Number	:	214-645-9729
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/14/2009
Last Update Date	:	09/30/2025

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Directions to “ LESLEY B. CONRAD M.D.” Practice Location

Language	Start Address	Practice Location

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