Dr. Leslie Edward Broline
Periodontist
3508 Far West Blvd Ste 330
Austin
, Texas 78731-3041
Dr. Leslie Edward Broline
Periodontist
3508 Far West Blvd Ste 330
Austin
, Texas 78731-3041
(512) 343-1062
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About
Features
Specialties
- Periodontist
Languages spoken
- English
Location
First Address
- Dr. Leslie Edward Broline
- 3508 Far West Blvd Ste 330
- Austin, TX
- Zip : 78731-3041
- Fax : (512) 343-1062
- Phone : (512) 343-9488
Second Address
- Dr. Leslie Edward Broline
- 3508 Far West Blvd Ste 330
- Austin, TX
- Zip : 78731-3041
- Fax : (512) 343-1062
- Phone : (512) 343-9488
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223P0300X | Periodontist | 9766 | TX |
National Provider Identifier
| NPI | 1154427029 |
|---|---|
| Provider Name | Dr. Leslie Edward Broline |
| First Address | Austin, TX 78731-3041 |
| Second Address | Austin, TX 78731-3041 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 16/09/2006 |
| Last Update Date | 08/07/2007 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.