Provider Demographics
NPI:1508006628
Name:SCONZERT, LESLIE JAYNE (PT)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:JAYNE
Last Name:SCONZERT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 HWY 407
Mailing Address - Street 2:SUITE 206
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75077-2124
Mailing Address - Country:US
Mailing Address - Phone:971-317-7775
Mailing Address - Fax:972-317-6356
Practice Address - Street 1:1301 HWY 407
Practice Address - Street 2:SUITE 206
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75077-2124
Practice Address - Country:US
Practice Address - Phone:971-317-7775
Practice Address - Fax:972-317-6356
Is Sole Proprietor?:No
Enumeration Date:2009-03-02
Last Update Date:2009-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1078103225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist