Healthcare Provider Details

I. General information

NPI: 1558061358
Provider Name (Legal Business Name): KAILLYN DEMOURY LEWIS DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2023
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15050 FAIRFIELD VILLAGE SQUARE DR STE 140
CYPRESS TX
77433-5739
US

IV. Provider business mailing address

PO BOX 700688
SAN ANTONIO TX
78270-0688
US

V. Phone/Fax

Practice location:
  • Phone: 800-404-6050
  • Fax: 866-313-3397
Mailing address:
  • Phone: 800-404-6050
  • Fax: 866-313-3397

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number15528
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: