MEDICARE: LESLIE SPRINGER RN

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	163WI0500X	Infusion Therapy Registered Nurse	716625	TX

General Provider Information

NPI Number	:	1679429237
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LESLIE SPRINGER RN

Provider Business Mailing Address
First Line	:	8690 GREEN BRANCH LOOP
Second Line	:
City	:	BRYAN
State	:	TX
Zip	:	77808-4929
Country	:	US
Telephone Number	:	979-205-4409
Fax Number	:

Provider Business Practice Location Address
First Line	:	4003 STATE HIGHWAY 6 S STE 500
Second Line	:
City	:	COLLEGE STATION
State	:	TX
Zip	:	77845-8963
Country	:	US
Telephone Number	:	979-205-4409
Fax Number	:

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

Provider Enumeration Date	:	03/06/2026
Last Update Date	:	03/06/2026

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