Provider Demographics
NPI:1578827390
Name:GREGG LESSLY MD PA
Entity Type:Organization
Organization Name:GREGG LESSLY MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:GREGG
Authorized Official - Middle Name:A
Authorized Official - Last Name:LESSLY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-747-5840
Mailing Address - Street 1:906 W MCDERMOTT DR
Mailing Address - Street 2:116-371
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-6510
Mailing Address - Country:US
Mailing Address - Phone:972-747-5840
Mailing Address - Fax:972-747-5841
Practice Address - Street 1:1105 CENTRAL EXPY N
Practice Address - Street 2:SUITE 380
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-6103
Practice Address - Country:US
Practice Address - Phone:972-747-5840
Practice Address - Fax:972-747-5841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-26
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty