Provider Demographics
NPI:1366534810
Name:LESLIE, WILLIAM K (M D)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:K
Last Name:LESLIE
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 210
Mailing Address - Street 2:
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75030-0210
Mailing Address - Country:US
Mailing Address - Phone:972-412-6969
Mailing Address - Fax:972-412-6639
Practice Address - Street 1:7801 LAKEVIEW PKWY
Practice Address - Street 2:SUITE 130
Practice Address - City:ROWLETT
Practice Address - State:TX
Practice Address - Zip Code:75088-4247
Practice Address - Country:US
Practice Address - Phone:972-412-6969
Practice Address - Fax:972-412-6639
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF6875207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX127086002Medicaid
TXB24357Medicare UPIN
TX00622JMedicare ID - Type Unspecified