MEDICARE: TAMARA LEWIS PT

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	225100000X	Physical Therapist	1185463	TX

General Provider Information

NPI Number	:	1659506160
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMARA LEWIS PT

Provider Business Mailing Address
First Line	:	827 MAGNOLIA BLVD
Second Line	:
City	:	MAGNOLIA
State	:	TX
Zip	:	77355-8602
Country	:	US
Telephone Number	:	281-277-0751
Fax Number	:	281-277-0761

Provider Business Practice Location Address
First Line	:	827 MAGNOLIA BLVD
Second Line	:
City	:	MAGNOLIA
State	:	TX
Zip	:	77355-8602
Country	:	US
Telephone Number	:	281-277-0751
Fax Number	:	281-277-0761

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

Provider Enumeration Date	:	05/28/2009
Last Update Date	:	08/03/2011

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Directions to “ TAMARA LEWIS PT” Practice Location

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