Provider Demographics
NPI:1437574456
Name:CUMBY, LESLIE (OWNER)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:
Last Name:CUMBY
Suffix:
Gender:M
Credentials:OWNER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10039 BISSONNET ST
Mailing Address - Street 2:SIUTE 312A
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-7854
Mailing Address - Country:US
Mailing Address - Phone:713-771-1554
Mailing Address - Fax:713-771-1559
Practice Address - Street 1:10039 BISSONNET ST
Practice Address - Street 2:SIUTE 312A
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-7854
Practice Address - Country:US
Practice Address - Phone:713-771-1554
Practice Address - Fax:713-771-1559
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-27
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver