Organization
LESTER B COLLINS III MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LESTER B COLLINS III M.D. (OWNER)
(903) 595-2643
Entity
Organization
Contact information
Practice address
700 OLYMPIC PLAZA CIR, SUITE 910, TYLER, TX 75701-1951
(903) 595-2643
(903) 595-6816
Mailing address
PO BOX 132419, TYLER, TX 75713-2419
(903) 595-2643
(903) 595-6816
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
E4263
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120213702
—
TX
Enumeration date
01/26/2012
Last updated
01/26/2012
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