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NPI Code Detail

MEDICARE: LESLIE HORNBERGER P.A.

MEDICARE:   LESLIE  HORNBERGER  P.A.
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
1363AM0700XMedical Physician AssistantTX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P01160311OTHERTXRAILROAD MEDICARE

General Provider Information

NPI Number : 1679870356
Entity Type Code : Individual
Provider Name (Legal Business Name) : LESLIE HORNBERGER P.A.
Provider Business Mailing Address
First Line : 2760 VIRGINIA PKWY STE 200
Second Line :
City : MCKINNEY
State : TX
Zip : 75071-4964
Country : US
Telephone Number : 469-587-7546
Fax Number : 214-544-6737
Provider Business Practice Location Address
First Line : 2760 VIRGINIA PKWY STE 200
Second Line :
City : MCKINNEY
State : TX
Zip : 75071-4964
Country : US
Telephone Number : 469-587-7546
Fax Number : 214-544-6737
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2011
Last Update Date : 06/05/2013

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