Smith, Leslie Wayne
Smith, Leslie Wayne is an individual health care provider with primary practice located at 855 Montgomery St , Fort Worth TX 76107-2553. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Addiction Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Smith, Leslie Wayne can be contacted via phone (817) 735-2400.Contact Information
Primary practice address
855 Montgomery St
Fort Worth TX 76107-2553
Phone: (817) 735-2400
Fax: (817) 735-0615
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 209098 | Massachusetts |
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 023829 | Connecticut |
| Allopathic & Osteopathic Physicians / Addiction Psychiatry | 2084P0802X | 209098 | Massachusetts |
| Allopathic & Osteopathic Physicians / Addiction Psychiatry | 2084P0802X | 023829 | Connecticut |
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | F2020 | Texas |
| Allopathic & Osteopathic Physicians / Addiction Psychiatry | 2084P0802X | F2020 | Texas |
Profile Details
| NPI number | 1336249630 |
|---|---|
| LBN Legal business name | Smith, Leslie Wayne |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 25th, 2006 |
| Last updated | Aug 9th, 2016 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1336249630 | NPPES |
| Connecticut | MEDICAID | 001238294 | |
| Connecticut | Other | P00998014 | |
| Connecticut | MEDICAID | 204374701 | |
| Connecticut | Other | 8X5119 |
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