Provider Demographics
NPI:1033390265
Name:ESTERS, JOHN R (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:R
Last Name:ESTERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2207 S CLEAR CREEK RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76549-4132
Mailing Address - Country:US
Mailing Address - Phone:254-519-2020
Mailing Address - Fax:254-519-3937
Practice Address - Street 1:2207 S CLEAR CREEK RD
Practice Address - Street 2:SUITE 202
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76549-4132
Practice Address - Country:US
Practice Address - Phone:254-519-2020
Practice Address - Fax:254-519-3937
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-15
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH5308152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00K38EOtherBLUE CROSS BLUE SHIELD
TXB66065OtherUPIN
TX91882OtherSCOTT & WHITE
TX00K38EOtherBLUE CROSS BLUE SHIELD