Provider Demographics
NPI:1790759371
Name:BALL-SCOVEL, LESLEE IONE (MD)
Entity Type:Individual
Prefix:DR
First Name:LESLEE
Middle Name:IONE
Last Name:BALL-SCOVEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:415 EMBASSY OAKS
Mailing Address - Street 2:STE 200
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-2040
Mailing Address - Country:US
Mailing Address - Phone:210-490-9087
Mailing Address - Fax:210-490-9111
Practice Address - Street 1:415 EMBASSY OAKS
Practice Address - Street 2:STE 200
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-2040
Practice Address - Country:US
Practice Address - Phone:210-490-9087
Practice Address - Fax:210-490-9111
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2013-01-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO119491207R00000X
TXM6035207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB126928OtherWELLMED MEDICAL GROUP PA
TXB126928OtherWELLMED MEDICAL GROUP PA