MEDICARE: DARYL LINDSAY LEWIS

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	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1396691929
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DARYL LINDSAY LEWIS

Provider Business Mailing Address
First Line	:	5604 SOUTHWEST PKWY APT 1018
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78735-6248
Country	:	US
Telephone Number	:	214-404-7824
Fax Number	:

Provider Business Practice Location Address
First Line	:	13341 W HWY 290 # 1018
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78737-9160
Country	:	US
Telephone Number	:	737-842-8996
Fax Number	:

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

Provider Enumeration Date	:	03/06/2026
Last Update Date	:	03/06/2026

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