Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | G0794 | TX |
Y | 208600000X | Surgeon | G0794 | TX |
N | 2086S0129X | Vascular Surgeon | 34729 | AZ |
N | 2086S0129X | Vascular Surgeon | G0794 | TX |
NPI | 1023067170 |
---|---|
Provider Name | Thomas Lowell Pester |
First Address | El Paso, TX 79902-2918 |
Second Address | El Paso, TX 79902-2918 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2006 |
Last Update Date | 28/02/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
11219601 | (05) | AZ |
126301402 | (05) | TX |
A01107 | (02) | |
A01107 | (02) | TX |