| Lester B Collins Iii Md Pc | |
|
700 Olympic Plaza Cir Suite 910 Tyler TX 75701-1951 | |
| (903) 595-2643 | |
| (903) 595-6816 |
| Full Name | Lester B Collins Iii Md Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 700 Olympic Plaza Cir, Tyler, Texas |
| Authorized Official Name and Position | Lester B Collins (OWNER) |
| Authorized Official Contact | 9035952643 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lester B Collins Iii Md Pc Po Box 132419 Tyler TX 75713-2419 Ph: (903) 595-2643 | Lester B Collins Iii Md Pc 700 Olympic Plaza Cir Suite 910 Tyler TX 75701-1951 Ph: (903) 595-2643 |
| NPI Number | 1568733251 |
|---|---|
| Provider Enumeration Date | 01/26/2012 |
| Last Update Date | 01/26/2012 |
| Medicare PECOS PAC ID | 1153589247 |
|---|---|
| Medicare Enrollment ID | O20120221000422 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568733251 | NPI | - | NPPES |
| 120213702 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | E4263 (Texas) | Primary |
| Provider Name | Lester B Collins |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1750305710 PECOS PAC ID: 2769472836 Enrollment ID: I20040512001440 |
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