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Individual
DR. JERRY L. LASTER
Active
Individual
DR. JERRY L. LASTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G8234
TX
207Q00000X
Family Medicine Physician
G8234
UT
208600000X
Surgery Physician
G8234
TX
208D00000X
General Practice Physician
G8234
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
181470901
—
TX
05
—
181470902
—
TX
05
—
181470903
—
TX
01
—
8F0717
BCBS
TX
01
—
P00720965
RAILROAD MEDICARE
TX
Enumeration date
07/16/2006
Last updated
06/28/2023
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