Kesterson, Oliver Lee

Kesterson, Oliver Lee is an individual health care provider with primary practice located at 1500 S Main St , Fort Worth TX 76104-4917. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurological Surgery, which is considered as his primary health care specialty. Kesterson, Oliver Lee can be contacted via phone (817) 702-3100.

Contact Information

Primary practice address
1500 S Main St Fort Worth TX 76104-4917
Phone: (817) 702-3100
Fax: (817) 927-3603
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X 18384 Mississippi
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X F9664 Texas

Profile Details

NPI number 1306997515
LBN Legal business name Kesterson, Oliver Lee
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 15th, 2007
Last updated Nov 30th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306997515 NPPES
Texas Other 646000515 TRICARE
Texas Other 646000515 TRICARE
Texas MEDICAID OK04289020 TRICARE

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