Provider Demographics
NPI:1205899549
Name:HARTMAN, LESLIE KOREL (MPT)
Entity type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:KOREL
Last Name:HARTMAN
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12700 BURKS CV
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78732-2104
Mailing Address - Country:US
Mailing Address - Phone:410-294-4868
Mailing Address - Fax:
Practice Address - Street 1:5000 BEE CAVES RD
Practice Address - Street 2:SUITE 200
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-5266
Practice Address - Country:US
Practice Address - Phone:512-328-8912
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-08
Last Update Date:2015-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD19019225100000X
TX1226473225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist