Provider Demographics
NPI:1174176580
Name:REESE, LEIGH LUNSFORD (FNP-C)
Entity type:Individual
Prefix:
First Name:LEIGH
Middle Name:LUNSFORD
Last Name:REESE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5531 BOCA RATON DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-2955
Mailing Address - Country:US
Mailing Address - Phone:832-515-4422
Mailing Address - Fax:
Practice Address - Street 1:3600 GASTON AVE STE 360
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-1903
Practice Address - Country:US
Practice Address - Phone:214-820-7246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-24
Last Update Date:2019-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP142225363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily