Provider Demographics
NPI:1659500973
Name:PARK, LESLEY RAMOS (MD)
Entity Type:Individual
Prefix:
First Name:LESLEY
Middle Name:RAMOS
Last Name:PARK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LESLEY
Other - Middle Name:ANN
Other - Last Name:RAMOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1327 LAKE POINTE PKWY
Mailing Address - Street 2:SUITE 525
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-4095
Mailing Address - Country:US
Mailing Address - Phone:281-637-7690
Mailing Address - Fax:281-637-8057
Practice Address - Street 1:1327 LAKE POINTE PKWY
Practice Address - Street 2:SUITE 525
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4095
Practice Address - Country:US
Practice Address - Phone:281-637-7699
Practice Address - Fax:281-637-8057
Is Sole Proprietor?:No
Enumeration Date:2009-07-08
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM7504207R00000X
MA237833207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine