Provider Demographics
NPI:1326047754
Name:NOWITZ, LESLIE JACOB (MD)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:JACOB
Last Name:NOWITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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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:77081-5333
Mailing Address - Country:US
Mailing Address - Phone:713-486-2900
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:77081-5333
Practice Address - Country:US
Practice Address - Phone:713-486-2900
Practice Address - Fax:713-664-1272
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXF0275207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
8DQ534OtherBCBS
P01135314OtherRAILROAD MEDICARE
TX118640506Medicaid
274711YNGQMedicare PIN
P01135314OtherRAILROAD MEDICARE