Provider Demographics
NPI:1184807083
Name:LESTER M. DYKE III MD. PA
Entity type:Organization
Organization Name:LESTER M. DYKE III MD. PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LESTER
Authorized Official - Middle Name:M
Authorized Official - Last Name:DYKE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-687-1581
Mailing Address - Street 1:1801 S. 5TH
Mailing Address - Street 2:SUITE #215
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503
Mailing Address - Country:US
Mailing Address - Phone:956-687-1581
Mailing Address - Fax:956-687-1548
Practice Address - Street 1:1801 S. 5TH
Practice Address - Street 2:SUITE #215
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503
Practice Address - Country:US
Practice Address - Phone:956-687-1581
Practice Address - Fax:956-687-1548
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-13
Last Update Date:2010-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00L87LOtherBCBS OF TX
TX1566028-01Medicaid
TXE04402Medicare UPIN
TX00L87LMedicare PIN
00L87LMedicare PIN
E04402Medicare UPIN