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General NPI Number Information
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NPI Number | 1669702585
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Entity Type | Organization
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Legal Business Name | DR. R. ANTON LESTER JR & ASSOCIATES
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Dates
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Enumeration Date | 12/29/2009
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Last Update Date | 10/05/2011
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Provider Practice Location Address
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Address Line | 214 W HOUSTON ST
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City | TYLER
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State | TX
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Zip | 75702-8136
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Country | US
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Telephone | 903-592-8101
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Fax | 903-526-0565
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Provider Business Mailing Address
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Address Line | 214 W HOUSTON ST
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City | TYLER
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State | TX
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Zip | 75702-8136
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Country | US
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Telephone | 903-592-8101
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Fax | 903-526-0565
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. R ANTON LESTER III
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Credential | D.O
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Telephone | 903-592-8101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | L7322
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 607316
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 681561
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | F3204
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License Number State | TX
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