Leslie W Dalton Jr, is a
Audiologist based in Canyon, Texas. Leslie W Dalton Jr is licensed to practice in Texas (license number 104700) and his current practice location is
2501 4th Ave, Canyon, Texas. He can be reached at his office (for appointments etc.) via phone at
(806) 651-5108.
NPI number for Leslie W Dalton Jr is 1043571938 and his current mailing address is 2415 15th Ave, Canyon, Texas. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1043571938.
Healthcare Provider's Profile
| Full Name | Leslie W Dalton Jr |
|---|
| Gender | Male |
|---|
| Speciality | Audiologist |
|---|
| Location | 2501 4th Ave, Canyon, Texas |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1043571938
- Provider Enumeration Date: 06/06/2012
- Last Update Date: 10/23/2012
Medical Identifiers
Medical identifiers for Leslie W Dalton Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1043571938 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 235Z00000X | Speech-language Pathologist | 104700 (Texas) | Secondary |
| 231H00000X | Audiologist | 104700 (Texas) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Leslie W Dalton Jr is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Leslie W Dalton Jr,
2415 15th Ave,
Canyon, TX 79015-5519
Ph: (806) 656-0788 | Leslie W Dalton Jr,
2501 4th Ave,
Canyon, TX 79016-0001
Ph: (806) 651-5108 |
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