Provider Demographics
NPI:1720045479
Name:LESTER, FREDERICK C (MD)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:C
Last Name:LESTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3600 GASTON AVE
Mailing Address - Street 2:#751
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-1800
Mailing Address - Country:US
Mailing Address - Phone:214-821-6580
Mailing Address - Fax:214-821-6584
Practice Address - Street 1:3600 GASTON AVE
Practice Address - Street 2:#751
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-1907
Practice Address - Country:US
Practice Address - Phone:214-821-6580
Practice Address - Fax:214-821-6584
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-27
Last Update Date:2011-11-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXF4209208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB24378Medicare ID - Type Unspecified