Provider Demographics
NPI:1285942805
Name:MELINE, LESTER A (PT)
Entity type:Individual
Prefix:
First Name:LESTER
Middle Name:A
Last Name:MELINE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 S CYNTHIA ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-1278
Mailing Address - Country:US
Mailing Address - Phone:956-630-6300
Mailing Address - Fax:
Practice Address - Street 1:2001 S CYNTHIA ST
Practice Address - Street 2:SUITE A
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1278
Practice Address - Country:US
Practice Address - Phone:956-630-6300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-16
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1191003225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist