Provider Demographics
NPI:1447481965
Name:DROEGE, LESLIE (LAC)
Entity type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:
Last Name:DROEGE
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10438 REMUDA VIEW DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78254-1760
Mailing Address - Country:US
Mailing Address - Phone:210-781-9795
Mailing Address - Fax:210-695-5773
Practice Address - Street 1:11820 BANDERA RD STE 208
Practice Address - Street 2:
Practice Address - City:HELOTES
Practice Address - State:TX
Practice Address - Zip Code:78023-4636
Practice Address - Country:US
Practice Address - Phone:210-781-9795
Practice Address - Fax:210-695-5773
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-31
Last Update Date:2009-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC01115171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist