Provider Demographics
NPI:1013384775
Name:LESLEY SCHMITZ D.O. AND ASSOCIATES
Entity Type:Organization
Organization Name:LESLEY SCHMITZ D.O. AND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LESLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHMITZ
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:214-762-5751
Mailing Address - Street 1:4545 BELLAIRE DR S
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76109-1889
Mailing Address - Country:US
Mailing Address - Phone:817-240-2343
Mailing Address - Fax:817-945-1038
Practice Address - Street 1:4545 BELLAIRE DR S
Practice Address - Street 2:SUITE 200
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76109-1889
Practice Address - Country:US
Practice Address - Phone:817-240-2343
Practice Address - Fax:817-945-1038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-28
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7877204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB162957Medicare PIN