Provider Demographics
NPI:1144460643
Name:FOLASHADE LESTER, M.D. PA
Entity type:Organization
Organization Name:FOLASHADE LESTER, M.D. PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:FOLASHADE
Authorized Official - Middle Name:F
Authorized Official - Last Name:LESTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-867-9300
Mailing Address - Street 1:3801 W 15TH ST
Mailing Address - Street 2:350-B
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-4737
Mailing Address - Country:US
Mailing Address - Phone:972-867-9300
Mailing Address - Fax:972-867-1700
Practice Address - Street 1:3801 W 15TH ST
Practice Address - Street 2:350-B
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-4737
Practice Address - Country:US
Practice Address - Phone:972-867-9300
Practice Address - Fax:972-867-1700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-24
Last Update Date:2009-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL2985207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH59127OtherUPIN