Provider Demographics
NPI:1174110159
Name:MCLEA, LESLIE CHRISTINA
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:CHRISTINA
Last Name:MCLEA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17610 GILA CLIFF LN
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-3571
Mailing Address - Country:US
Mailing Address - Phone:128-146-8184
Mailing Address - Fax:
Practice Address - Street 1:17610 GILA CLIFF LN
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77346-3571
Practice Address - Country:US
Practice Address - Phone:128-146-8184
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-24
Last Update Date:2020-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX211883163WX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0106XNursing Service ProvidersRegistered NurseOccupational Health