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Individual
DR. JACK W LESCH
Active
Individual
DR. JACK W LESCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M. D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E5402
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E-5402
STATE LICENSE NUMBER
TX
Enumeration date
11/28/2006
Last updated
09/07/2012
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