MEDICARE: LEWIS HEALTH CARE FACILITY INC

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	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)	1072420001
2	332BN1400X	Nursing Facility Supplies (DME)	DME00G318	TX
3	313M00000X	Nursing Facility/Intermediate Care Facility		TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DME00G318	OTHER	TX	STATE LICENSE #

General Provider Information

NPI Number	:	1225019755
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEWIS HEALTH CARE FACILITY INC

Provider Business Mailing Address
First Line	:	PO BOX 889
Second Line	:
City	:	PORTER
State	:	TX
Zip	:	77365-0889
Country	:	US
Telephone Number	:	281-354-2155
Fax Number	:	281-354-6515

Provider Business Practice Location Address
First Line	:	23450 PINE SHADOW LANE
Second Line	:
City	:	PORTER
State	:	TX
Zip	:	77365-0889
Country	:	US
Telephone Number	:	281-354-2155
Fax Number	:	281-354-6515

Authorized Official
Title or Position	:	ASSISTANT ADMINISTRATOR
Name	:	MRS. BETTY LEWIS SWABADO
Credential	:
Telephone Number	:	281-354-2155

Provider Enumeration Date	:	11/10/2005
Last Update Date	:	09/11/2025

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