MEDICARE: BRANDI LEWIS DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DD4608	NM
2	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	65248	CA
3	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	38402	TX

General Provider Information

NPI Number	:	1164970505
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRANDI LEWIS DDS

Provider Business Mailing Address
First Line	:	3921 WOODSONS RESERVE PKWY STE 900
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77386-4973
Country	:	US
Telephone Number	:	832-838-9467
Fax Number	:

Provider Business Practice Location Address
First Line	:	3921 WOODSONS RESERVE PKWY STE 900
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77386-4973
Country	:	US
Telephone Number	:	832-838-9467
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/14/2016
Last Update Date	:	03/12/2026

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Directions to “ BRANDI LEWIS DDS” Practice Location

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