Provider Demographics
NPI:1316930514
Name:WILLIAMS, LESTER BERT (DC)
Entity type:Individual
Prefix:
First Name:LESTER
Middle Name:BERT
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:L
Other - Middle Name:BERT
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:3960 FM 1960 RD W
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77068-3521
Mailing Address - Country:US
Mailing Address - Phone:281-440-6355
Mailing Address - Fax:281-440-0401
Practice Address - Street 1:3960 FM 1960 RD W
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77068-3521
Practice Address - Country:US
Practice Address - Phone:281-440-6355
Practice Address - Fax:281-440-0401
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-24
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC 2391111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
4357782OtherAETNA
8J2950OtherBCBS
8B2912Medicare ID - Type Unspecified
8J2950OtherBCBS