Provider Demographics
NPI:1568637320
Name:SMITH, LESLIE KUCERA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:KUCERA
Last Name:SMITH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6520 FRATT RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78218-4485
Mailing Address - Country:US
Mailing Address - Phone:210-938-9090
Mailing Address - Fax:
Practice Address - Street 1:1101 S INTERSTATE 35
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78626-5400
Practice Address - Country:US
Practice Address - Phone:512-869-4287
Practice Address - Fax:512-930-9777
Is Sole Proprietor?:No
Enumeration Date:2008-04-23
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX43262183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist