Provider Demographics
NPI:1013960426
Name:RESTER, JAMES TREVER (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:TREVER
Last Name:RESTER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1101 W I30
Mailing Address - Street 2:SUITE # 101
Mailing Address - City:ROYSE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:75189
Mailing Address - Country:US
Mailing Address - Phone:972-636-9144
Mailing Address - Fax:972-636-9146
Practice Address - Street 1:METHODIST FAMILY HEALTH CENTER - FIREWHEEL
Practice Address - Street 2:4430 LAVON DRIVE, STE 350
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040
Practice Address - Country:US
Practice Address - Phone:972-530-8590
Practice Address - Fax:972-530-8625
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2020-01-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXJ7362208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX105124502Medicaid
TX105124501Medicaid
TX86109GOtherBCBS
TX110171756OtherRR MEDICARE