Provider Demographics
NPI:1609021336
Name:KRANZ, LESLEY MARIE (MSPT)
Entity Type:Individual
Prefix:
First Name:LESLEY
Middle Name:MARIE
Last Name:KRANZ
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3311 N I-35
Mailing Address - Street 2:#110
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76207-2004
Mailing Address - Country:US
Mailing Address - Phone:940-320-6219
Mailing Address - Fax:940-320-6230
Practice Address - Street 1:3311 N I-35
Practice Address - Street 2:#110
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76207-2004
Practice Address - Country:US
Practice Address - Phone:940-320-6219
Practice Address - Fax:940-320-6230
Is Sole Proprietor?:No
Enumeration Date:2008-11-21
Last Update Date:2009-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1116713225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8L11432OtherMEDICARE PTAN INDIVIDUAL
TX00X511OtherMEDICARE PTAN GROUP