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NPI Code Detail

MEDICARE: MR. LEWIS MCDONALD

MEDICARE: MR. LEWIS MCDONALD
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
1101Y00000XCounselor72447TX

General Provider Information

NPI Number : 1245641661
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. LEWIS MCDONALD
Provider Business Mailing Address
First Line : 185 EASTGATE PLZ
Second Line :
City : WACO
State : TX
Zip : 76705-2868
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 185 EASTGATE PLZ
Second Line :
City : WACO
State : TX
Zip : 76705-2868
Country : US
Telephone Number : 254-412-2667
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2014
Last Update Date : 05/20/2014

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Directions to “ MR. LEWIS MCDONALD ” Practice Location

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