Provider Demographics
NPI:1396841714
Name:LESTER-RODRIGUEZ, REGAN (PHD)
Entity Type:Individual
Prefix:MS
First Name:REGAN
Middle Name:
Last Name:LESTER-RODRIGUEZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 163446
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78716-3446
Mailing Address - Country:US
Mailing Address - Phone:512-329-0881
Mailing Address - Fax:512-329-0876
Practice Address - Street 1:3530 BEE CAVE RD
Practice Address - Street 2:SUITE 110
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-5391
Practice Address - Country:US
Practice Address - Phone:512-329-0881
Practice Address - Fax:512-329-0876
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX26884103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0092NTOtherBC / BS NUMBER
TX7487002OtherAETNA NUMBER