Provider Demographics
NPI:1255738951
Name:BREW, LESLIE
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:
Last Name:BREW
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13903 ELMPARK CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77014-2770
Mailing Address - Country:US
Mailing Address - Phone:713-248-4428
Mailing Address - Fax:
Practice Address - Street 1:13903 ELMPARK CT
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77014-2770
Practice Address - Country:US
Practice Address - Phone:713-248-4428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-24
Last Update Date:2014-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle