Leslie R Demetri Sr., MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

D9417 Issued in TX

Practice address

2810 Dacy LN
Kyle, TX 78640-6322

Phone

(512) 268-8900

Fax

(512) 268-2250

NPI assigned

Apr 2, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1760503577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3066 E COMMERCE ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782201013",
            "telephone_number": "210-233-7000",
            "fax_number": "210-277-6387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2810 DACY LN",
            "city": "KYLE",
            "state": "TX",
            "postal_code": "786406322",
            "telephone_number": "512-268-8900",
            "fax_number": "512-268-2250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMETRI",
        "first_name": "LESLIE",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-02",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TX",
            "license": "D9417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Kyle, TX
• Providers in Kyle, TX by specialty
• General Practice Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.