Provider Demographics
NPI:1013268283
Name:MAXWELL, LESLIE C (DC)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:C
Last Name:MAXWELL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:LESLIE
Other - Middle Name:C
Other - Last Name:FINLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:9701 BRODIE LN
Mailing Address - Street 2:SUITE 202
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78748-6282
Mailing Address - Country:US
Mailing Address - Phone:512-326-2520
Mailing Address - Fax:512-326-1355
Practice Address - Street 1:9701 BRODIE LN
Practice Address - Street 2:SUITE 202
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78748-6282
Practice Address - Country:US
Practice Address - Phone:512-326-2520
Practice Address - Fax:512-326-1355
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-27
Last Update Date:2016-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12158111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor