Provider Demographics
NPI:1376588905
Name:LESSENGER, ELVIN WAYNE (DC)
Entity Type:Individual
Prefix:DR
First Name:ELVIN
Middle Name:WAYNE
Last Name:LESSENGER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:306 S FRIENDSWOOD DR
Mailing Address - Street 2:STE D
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546-3982
Mailing Address - Country:US
Mailing Address - Phone:281-993-0464
Mailing Address - Fax:281-993-0565
Practice Address - Street 1:306 S FRIENDSWOOD DR
Practice Address - Street 2:STE D
Practice Address - City:FRIENDSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77546-3982
Practice Address - Country:US
Practice Address - Phone:281-993-0464
Practice Address - Fax:281-993-0565
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-18
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX8405111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX606090OtherBCBS PROVIDER ID
TX650802OtherUNITED PROVIDER ID
TX1416968-01Medicaid
TX650802OtherUNITED PROVIDER ID