Provider Demographics
NPI:1558308387
Name:GERSON, LESTER PAUL (MD)
Entity Type:Individual
Prefix:
First Name:LESTER
Middle Name:PAUL
Last Name:GERSON
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 1:7026 OLD KATY RD STE 276
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2187
Mailing Address - Country:US
Mailing Address - Phone:713-621-7436
Mailing Address - Fax:281-446-1704
Practice Address - Street 1:9802 FM 1960 BYPASS RD W
Practice Address - Street 2:SUITE 245
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-3501
Practice Address - Country:US
Practice Address - Phone:281-359-2500
Practice Address - Fax:281-446-1704
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD24292085N0700X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX137783011Medicaid
TX8F4542Medicare PIN
TX84490RMedicare ID - Type UnspecifiedHARRIS CO
TX137783011Medicaid
TX8F0241Medicare ID - Type UnspecifiedMONTGOMERY CO