| Leslie Wade King | |
|
2500 E Tc Jester Blvd Suite 267 Houston TX 77008-1365 | |
| (713) 934-8121 | |
| (713) 490-3167 |
| Full Name | Leslie Wade King |
|---|---|
| Speciality | Counselor |
| Location | 2500 E Tc Jester Blvd, Houston, Texas |
| Authorized Official Name and Position | Leslie Wade King (OWNER) |
| Authorized Official Contact | 7139348121 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Leslie Wade King 16303 Drystone Ln Houston TX 77095-4534 Ph: (713) 934-8121 | Leslie Wade King 2500 E Tc Jester Blvd Suite 267 Houston TX 77008-1365 Ph: (713) 934-8121 |
| NPI Number | 1346291523 |
|---|---|
| Provider Enumeration Date | 05/13/2006 |
| Last Update Date | 03/16/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346291523 | NPI | - | NPPES |
| 211735001 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | 15291 (Texas) | Primary |
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