Provider Demographics
NPI:1548283401
Name:LESLEY SHURE, MD, PLLC
Entity type:Organization
Organization Name:LESLEY SHURE, MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:LESLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHURE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-561-7236
Mailing Address - Street 1:9150 HUEBNER RD STE 350
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-1305
Mailing Address - Country:US
Mailing Address - Phone:210-561-7236
Mailing Address - Fax:210-561-7240
Practice Address - Street 1:9150 HUEBNER RD STE 350
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1305
Practice Address - Country:US
Practice Address - Phone:210-561-7236
Practice Address - Fax:210-561-7240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY39879207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty