Provider Demographics
NPI:1922431774
Name:BEGGS, LESLIE COLLEEN (RD)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:COLLEEN
Last Name:BEGGS
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:LESLIE
Other - Middle Name:COLLEEN
Other - Last Name:VEST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, LD
Mailing Address - Street 1:1846 LOCKHILL SELMA RD STE 106
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78213-1551
Mailing Address - Country:US
Mailing Address - Phone:530-383-9705
Mailing Address - Fax:
Practice Address - Street 1:1846 LOCKHILL SELMA RD STE 106
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78213-1551
Practice Address - Country:US
Practice Address - Phone:530-383-9705
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-15
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1011527133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered