Basic Information
Provider Information
NPI: 1699154971
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LESSANS
FirstName: GREGORY
MiddleName: MATTHEW
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2450 HOLCOMBE BLVD STE NB-34L
Address2:  
City: HOUSTON
State: TX
PostalCode: 770212039
CountryCode: US
TelephoneNumber: 8328283660
FaxNumber:  
Practice Location
Address1: 6621 FANNIN ST
Address2:  
City: HOUSTON
State: TX
PostalCode: 770302358
CountryCode: US
TelephoneNumber: 2037852802
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/20/2015
LastUpdateDate: 03/13/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/13/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XS5004TXY193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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