Provider Demographics
NPI:1942401344
Name:KESSLER, DENNIS RAY
Entity Type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:RAY
Last Name:KESSLER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:344 LCR 759
Mailing Address - Street 2:
Mailing Address - City:GROESBECK
Mailing Address - State:TX
Mailing Address - Zip Code:76642
Mailing Address - Country:US
Mailing Address - Phone:254-729-8527
Mailing Address - Fax:
Practice Address - Street 1:344 LCR 759
Practice Address - Street 2:
Practice Address - City:GROESBECK
Practice Address - State:TX
Practice Address - Zip Code:76642
Practice Address - Country:US
Practice Address - Phone:254-729-8527
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0916100001Medicare ID - Type Unspecified