Provider Demographics
NPI:1932435443
Name:BIPPERT, LESLEY MICHELLE (AUDIOLOGIST)
Entity Type:Individual
Prefix:MS
First Name:LESLEY
Middle Name:MICHELLE
Last Name:BIPPERT
Suffix:
Gender:F
Credentials:AUDIOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2679
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78299-2679
Mailing Address - Country:US
Mailing Address - Phone:210-616-0096
Mailing Address - Fax:210-614-1003
Practice Address - Street 1:7940 FLOYD CURL
Practice Address - Street 2:SUITE 400
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3907
Practice Address - Country:US
Practice Address - Phone:210-616-0096
Practice Address - Fax:210-614-1003
Is Sole Proprietor?:No
Enumeration Date:2009-10-19
Last Update Date:2012-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80103231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX530294OtherBCBS
TX112774801Medicaid
TX00061SMedicare PIN