MEDICARE: BRONSON LESTER DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	12101	TX

General Provider Information

NPI Number	:	1588900369
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRONSON LESTER DC

Provider Business Mailing Address
First Line	:	3330 W 7TH ST
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76107-2715
Country	:	US
Telephone Number	:	682-730-5744
Fax Number	:

Provider Business Practice Location Address
First Line	:	3330 W 7TH ST
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76107-2715
Country	:	US
Telephone Number	:	806-392-1232
Fax Number	:	806-392-1232

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/22/2012
Last Update Date	:	06/16/2016

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Directions to “ BRONSON LESTER DC” Practice Location

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