Provider Demographics
NPI:1235823105
Name:LOPEZ-MORALES, LESLIBET
Entity Type:Individual
Prefix:MS
First Name:LESLIBET
Middle Name:
Last Name:LOPEZ-MORALES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2136 W 34TH ST APT 146
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77018-6070
Mailing Address - Country:US
Mailing Address - Phone:786-593-8037
Mailing Address - Fax:
Practice Address - Street 1:2136 W 34TH ST APT 146
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77018-6070
Practice Address - Country:US
Practice Address - Phone:786-593-8037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-05
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider