Provider Demographics
NPI:1528042009
Name:ROWE, LESLIE T (DPM)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:T
Last Name:ROWE
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 MARBLE HTS
Mailing Address - Street 2:
Mailing Address - City:MARBLE FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:78654-4543
Mailing Address - Country:US
Mailing Address - Phone:830-693-8144
Mailing Address - Fax:830-693-8145
Practice Address - Street 1:1001 MARBLE HTS
Practice Address - Street 2:
Practice Address - City:MARBLE FALLS
Practice Address - State:TX
Practice Address - Zip Code:78654-4543
Practice Address - Country:US
Practice Address - Phone:830-693-8144
Practice Address - Fax:830-693-8145
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1745213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1783839-01Medicaid
TNV07176Medicare UPIN
TX1783839-01Medicaid