MEDICARE: DR. LESLEY ROBLES-PEREZ DDS

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	1223G0001X	General Practice Dentistry	40601	TX

General Provider Information

NPI Number	:	1528769031
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LESLEY ROBLES-PEREZ DDS

Provider Business Mailing Address
First Line	:	6710 N LOOP 1604 E APT 2210
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78247-5017
Country	:	US
Telephone Number	:	956-874-9807
Fax Number	:

Provider Business Practice Location Address
First Line	:	1659 STATE HIGHWAY 46 W STE 180
Second Line	:
City	:	NEW BRAUNFELS
State	:	TX
Zip	:	78132-4746
Country	:	US
Telephone Number	:	830-625-6600
Fax Number	:

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

Provider Enumeration Date	:	03/13/2023
Last Update Date	:	08/07/2024

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