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NPI Code Detail

MEDICARE: BRANDI LEWIS DDS

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
1122300000XDentistDD4608NM
21223X0400XOrthodontics and Dentofacial Orthopedics Dentistry65248CA
31223X0400XOrthodontics and Dentofacial Orthopedics Dentistry38402TX

General Provider Information

NPI Number : 1164970505
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRANDI LEWIS DDS
Provider Business Mailing Address
First Line : 9205 EAGLE DR STE 100
Second Line :
City : MONT BELVIEU
State : TX
Zip : 77523-5620
Country : US
Telephone Number : 832-479-0062
Fax Number : 832-479-0064
Provider Business Practice Location Address
First Line : 9205 EAGLE DR STE 100
Second Line :
City : MONT BELVIEU
State : TX
Zip : 77523-5620
Country : US
Telephone Number : 832-479-0062
Fax Number : 832-479-0064
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2016
Last Update Date : 06/28/2022

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Directions to “ BRANDI LEWIS DDS” Practice Location

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