Leslie Ann Rendon

Individual provider Active NPI Contractor · San Angelo, TX

NPI 1417340910 · NPPES record last updated Mar 9, 2015

Key facts

NPI
1417340910
Entity type
Individual (NPI type 1)
Primary specialty
Contractor 171W00000X
Practice address
1213 Rita Cir
San Angelo, TX 76905-4201
Phone
(325) 703-1139
NPI assigned
Mar 9, 2015
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X Yes

Addresses

Primary practice location

1213 Rita Cir
San Angelo, TX 76905-4201

Mailing address

1213 Rita Cir
San Angelo, TX 76905-4201
Phone (325) 703-1139

Other providers in San Angelo, TX

All providers in San Angelo, TX · Contractor in Texas

Sources for this page

Verify at the official NPI Registry.