Provider Demographics
NPI:1174970768
Name:NEIPERT, LESLIE (PHD)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:
Last Name:NEIPERT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 WILDERNESS TRL
Mailing Address - Street 2:
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546-5301
Mailing Address - Country:US
Mailing Address - Phone:406-327-6834
Mailing Address - Fax:
Practice Address - Street 1:1002 GEMINI ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-2746
Practice Address - Country:US
Practice Address - Phone:281-218-8181
Practice Address - Fax:281-218-7676
Is Sole Proprietor?:No
Enumeration Date:2016-05-24
Last Update Date:2016-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36983103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist