Provider Demographics
NPI:1962651901
Name:HINTON, LESLIE (LMT)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:
Last Name:HINTON
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6211 W NORTHWEST HWY STE C255
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225-3498
Mailing Address - Country:US
Mailing Address - Phone:214-691-1225
Mailing Address - Fax:
Practice Address - Street 1:6211 W NORTHWEST HWY STE C255
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75225-3498
Practice Address - Country:US
Practice Address - Phone:214-691-1225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-15
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT031487225700000X
TXMT127618225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXMT127618OtherTEXAS DEPARTMENT OF STATE HEALTH SERVICES