Healthcare Provider Details

I. General information

NPI: 1013960426
Provider Name (Legal Business Name): JAMES TREVER RESTER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 01/09/2020
Certification Date: 01/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

METHODIST FAMILY HEALTH CENTER - FIREWHEEL 4430 LAVON DRIVE, STE 350
GARLAND TX
75040
US

IV. Provider business mailing address

1101 W I30 SUITE # 101
ROYSE CITY TX
75189
US

V. Phone/Fax

Practice location:
  • Phone: 972-530-8590
  • Fax: 972-530-8625
Mailing address:
  • Phone: 972-636-9144
  • Fax: 972-636-9146

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberJ7362
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberJ7362
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: