Provider Demographics
NPI:1548242688
Name:ROBERTS, LESHA DAWN (DC)
Entity Type:Individual
Prefix:MISS
First Name:LESHA
Middle Name:DAWN
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1710 S DAIRY ASHFORD RD STE 109
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-3859
Mailing Address - Country:US
Mailing Address - Phone:281-870-1233
Mailing Address - Fax:281-870-1037
Practice Address - Street 1:1710 S DAIRY ASHFORD RD STE 109
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-3853
Practice Address - Country:US
Practice Address - Phone:281-870-1233
Practice Address - Fax:281-870-1037
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-15
Last Update Date:2013-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5259111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX88H221Medicare PIN