Provider Demographics
NPI:1356023428
Name:JURADO, LESLIE (PA-C)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:
Last Name:JURADO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 ADAMS AVE
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79761-1384
Mailing Address - Country:US
Mailing Address - Phone:432-934-9150
Mailing Address - Fax:
Practice Address - Street 1:5913 VIRGINIA PKWY STE 300
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-5627
Practice Address - Country:US
Practice Address - Phone:972-542-4646
Practice Address - Fax:972-542-0909
Is Sole Proprietor?:No
Enumeration Date:2023-08-07
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical