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General NPI Number Information
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NPI Number | 1457465791
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Entity Type | Organization
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Legal Business Name | LESTER R KITCHEN OPTOMETRIST INC
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 11/20/2008
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Provider Practice Location Address
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Address Line | 500 CANYON RDG SUITE L-350
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City | AUSTIN
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State | TX
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Zip | 78753-1632
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Country | US
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Telephone | 512-837-3200
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Fax | 512-837-3206
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Provider Business Mailing Address
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Address Line | 500 CANYON RDG SUITE L-350
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City | AUSTIN
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State | TX
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Zip | 78753-1632
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Country | US
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Telephone | 512-837-3200
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Fax | 512-837-3206
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Authorized Official
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Title or Position | PRESIDENT
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Name | LESTER R KITCHEN
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Credential | O.D.
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Telephone | 512-837-3200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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