Provider Demographics
NPI:1790251486
Name:SASSO, LESLIE (LVN)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:
Last Name:SASSO
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1209 CATBIRD DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ELM
Mailing Address - State:TX
Mailing Address - Zip Code:75068-8517
Mailing Address - Country:US
Mailing Address - Phone:432-880-4968
Mailing Address - Fax:
Practice Address - Street 1:1255 W 15TH ST STE 1025
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-7253
Practice Address - Country:US
Practice Address - Phone:855-704-2700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-19
Last Update Date:2018-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX344186164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse