Provider Demographics
NPI:1225159346
Name:MOORE, LEIGH ANN (OTR)
Entity Type:Individual
Prefix:MS
First Name:LEIGH
Middle Name:ANN
Last Name:MOORE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3012 VIDALIA LN
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-5420
Mailing Address - Country:US
Mailing Address - Phone:972-377-8755
Mailing Address - Fax:
Practice Address - Street 1:3201 E PRESIDENT GEORGE BUSH HWY STE 103
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75082-3565
Practice Address - Country:US
Practice Address - Phone:972-470-5005
Practice Address - Fax:972-470-5009
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX105495225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand