Organization
HOMETOWN PEDIATRIC CARE, PA
Active
Other names
Stephen M. Dentler, DO, PA
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DILLON KELBY LESAK DO (OWNER/PEDIATRICIAN)
(361) 579-1333
Entity
Organization
Contact information
Practice address
9410 NE ZAC LENTZ PKWY,, SUITE 202, VICTORIA, TX 77904-3108
(361) 579-1333
(361) 579-1334
Mailing address
9410 NE ZAC LENTZ PKWY,, SUITE 202, VICTORIA, TX 77904-3108
(361) 579-1333
(361) 579-1334
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
J4080
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0087CL
BLUE CROSS BLUE SHIELD
TX
01
—
10049506
AMERIGROUP
TX
05
—
111836604
—
TX
05
—
111836605
—
TX
01
—
5965594
AETNA
TX
Enumeration date
10/05/2007
Last updated
06/12/2025
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