Individual provider Active NPI

Leslie Dehart, NP

  • Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1043690324
Registry record updated Mar 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP128090 Issued in TX
Practice address
21 Spurs LN
Ste 100
San Antonio, TX 78240-1669
Phone
(210) 614-6070
Fax
(210) 615-6814
NPI assigned
Jun 2, 2015
Last updated
Mar 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP128090 TX Primary

Addresses

Primary practice location

21 Spurs LN
Ste 100
San Antonio, TX 78240-1669

Mailing address

1303 McCullough Ave Ste 248
San Antonio, TX 78212-5604
Phone (210) 220-3737

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230406002788 TX Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 8224340930

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP128090TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Daniel Juarez, MD PA CurrentSince Apr 6, 2023 Accepting new patients

Locations

1303 McCullough Ave
Ste 248
San Antonio, TX 78212
Phone (210) 220-3737

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1433203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1043690324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 MCCULLOUGH AVE STE 248",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782125604",
            "telephone_number": "210-220-3737",
            "fax_number": "210-220-3747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 SPURS LN",
            "address_2": "STE 100",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782401669",
            "telephone_number": "210-614-6070",
            "fax_number": "210-615-6814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEHART",
        "first_name": "LESLIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-02",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP128090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.