Provider Demographics
NPI:1508389123
Name:LESTER, JORDAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JORDAN
Middle Name:
Last Name:LESTER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3510 N MIDKIFF RD STE 100
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79705-4834
Mailing Address - Country:US
Mailing Address - Phone:432-697-7500
Mailing Address - Fax:
Practice Address - Street 1:3510 N MIDKIFF RD STE 100
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79705-4834
Practice Address - Country:US
Practice Address - Phone:432-697-7500
Practice Address - Fax:432-697-7500
Is Sole Proprietor?:No
Enumeration Date:2017-07-25
Last Update Date:2017-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX60715183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist