Provider Demographics
NPI:1801145115
Name:RICHARDS, LESLIE (PT)
Entity type:Individual
Prefix:MS
First Name:LESLIE
Middle Name:
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:677 ALA MOANA BLVD
Mailing Address - Street 2:725
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-5419
Mailing Address - Country:US
Mailing Address - Phone:808-734-0010
Mailing Address - Fax:808-734-0013
Practice Address - Street 1:201 N COLLEGIATE DR
Practice Address - Street 2:SUITE 550
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75460-1494
Practice Address - Country:US
Practice Address - Phone:903-784-3173
Practice Address - Fax:903-784-7912
Is Sole Proprietor?:No
Enumeration Date:2012-08-31
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1221576225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist