Provider Demographics
NPI:1245239672
Name:GARB, LESLIE JULIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:JULIAN
Last Name:GARB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5420 DASHWOOD DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77081-5357
Mailing Address - Country:US
Mailing Address - Phone:713-664-0719
Mailing Address - Fax:713-664-1272
Practice Address - Street 1:5420 DASHWOOD DR
Practice Address - Street 2:SUITE 100
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081-5357
Practice Address - Country:US
Practice Address - Phone:713-664-0719
Practice Address - Fax:713-664-1272
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE8494207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX122738105Medicaid
TX881551OtherBCBS OF TEXAS
TX080182302OtherRAILROAD MEDICARE
TX122738105Medicaid
TX8461B1Medicare ID - Type Unspecified