Provider Demographics
NPI:1366464943
Name:LESTON, ALISON M (MD)
Entity Type:Individual
Prefix:MISS
First Name:ALISON
Middle Name:M
Last Name:LESTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:PO BOX 845347
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-5347
Mailing Address - Country:US
Mailing Address - Phone:214-645-8800
Mailing Address - Fax:214-645-8801
Practice Address - Street 1:5323 HARRY HINES BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-7208
Practice Address - Country:US
Practice Address - Phone:214-645-8800
Practice Address - Fax:214-645-8801
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2014-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20050146892084N0400X
TXP96322084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200549509Medicaid
MOI50545Medicare UPIN
MO939132262Medicare PIN