Provider Demographics
NPI:1538378310
Name:CLER, LESLIE RYAN (MD)
Entity type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:RYAN
Last Name:CLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1441 N BECKLEY AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75203-1201
Mailing Address - Country:US
Mailing Address - Phone:214-947-2385
Mailing Address - Fax:214-947-2390
Practice Address - Street 1:1441 N BECKLEY AVE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75203-1201
Practice Address - Country:US
Practice Address - Phone:214-947-2385
Practice Address - Fax:214-947-2390
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN1591207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
BP1-0026131OtherINSTITUTIONAL PERMIT
TXA0164212OtherDPS
TX204084201Medicaid
TXN1591OtherPHYSICIAN PERMIT
TXN1591OtherPHYSICIAN PERMIT