Provider Demographics
NPI:1073803771
Name:FRATER, LESLIE A (PT)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:A
Last Name:FRATER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:279 W MAIN ST
Mailing Address - Street 2:SUITE 114
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-4306
Mailing Address - Country:US
Mailing Address - Phone:214-494-4643
Mailing Address - Fax:214-494-4654
Practice Address - Street 1:279 W MAIN ST
Practice Address - Street 2:SUITE 114
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-4306
Practice Address - Country:US
Practice Address - Phone:214-494-4643
Practice Address - Fax:214-494-4654
Is Sole Proprietor?:No
Enumeration Date:2011-04-14
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1155693225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist