Provider Demographics
NPI:1851610851
Name:BORGSTEDTE, LEILA (ANP-BC)
Entity Type:Individual
Prefix:
First Name:LEILA
Middle Name:
Last Name:BORGSTEDTE
Suffix:
Gender:F
Credentials:ANP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6065 HILLCROFT ST STE 107
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77081-1005
Mailing Address - Country:US
Mailing Address - Phone:713-636-2240
Mailing Address - Fax:
Practice Address - Street 1:6065 HILLCROFT ST STE 107
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081-1005
Practice Address - Country:US
Practice Address - Phone:713-636-2240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-31
Last Update Date:2010-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX546906363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health