Provider Demographics
NPI:1710958400
Name:BROWN, LESLIE MICHELLE (MD)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:MICHELLE
Last Name:BROWN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7430 BARLITE BLVD
Mailing Address - Street 2:STE 105
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78224-1366
Mailing Address - Country:US
Mailing Address - Phone:210-922-2727
Mailing Address - Fax:210-922-9192
Practice Address - Street 1:7430 BARLITE BLVD
Practice Address - Street 2:STE 105
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78224-1366
Practice Address - Country:US
Practice Address - Phone:210-922-2727
Practice Address - Fax:210-922-9192
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MS21542207V00000X
TXS9110207V00000X
GA76946207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS302I164818Medicare PIN
MS302I164818Medicare PIN