| Doctor Name: | DR. LESLIE F STORK |
| NPI Number: | 1831197847 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | M7660 |
| Business Practice Address: | 32665 Us Highway 281 N Suite 202 Bulverde, TX - 781633124 |
| Business Phone Number: | 8309808433 |
| Business Fax Number: | 8309808442 |
| Mailing Address: | 8637 Fredericksburg Road, Suite 360 SAN ANTONIO |
| State: | TX |
| Postal Code: | 78240 |
| Phone Number: | 2109494179 |
| Fax Number: | 2106174075 |
| NPI Enumeration Date: | 07/13/2005 |
| NPI Last Update Date: | 09/26/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207QA0505X |
| License Number: | M7660 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Family Medicine |
| Taxonomy Specialization: | Adult Medicine |
| Taxonomy Definition: | |