Provider Demographics
NPI:1437763844
Name:HILBURN, LESLIE ANNE
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:ANNE
Last Name:HILBURN
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 1:3730 KIRBY DRIVE, STE 1200
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-3985
Mailing Address - Country:US
Mailing Address - Phone:281-888-8999
Mailing Address - Fax:281-305-4054
Practice Address - Street 1:6419 POLARIS DRIVE
Practice Address - Street 2:B2
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-7804
Practice Address - Country:US
Practice Address - Phone:281-888-8999
Practice Address - Fax:281-305-4054
Is Sole Proprietor?:No
Enumeration Date:2020-09-02
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1010196363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily