Healthcare Provider Details

I. General information

NPI: 1093733214
Provider Name (Legal Business Name): JARY M LESSER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 07/14/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 MOURSUND ST
HOUSTON TX
77030-3406
US

IV. Provider business mailing address

PO BOX 201088
HOUSTON TX
77216-1088
US

V. Phone/Fax

Practice location:
  • Phone: 713-500-2500
  • Fax:
Mailing address:
  • Phone: 713-500-3500
  • Fax: 713-500-5484

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberE2677
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License NumberE2677
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: