Healthcare Provider Details

I. General information

NPI: 1356738181
Provider Name (Legal Business Name): COLE LEWIS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2015
Last Update Date: 01/03/2025
Certification Date: 01/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6400 FANNIN ST SUITE 2800
HOUSTON TX
77030-1521
US

IV. Provider business mailing address

1111 MEDICAL CENTER BLVD STE S750
MARRERO LA
70072-3197
US

V. Phone/Fax

Practice location:
  • Phone: 713-704-7100
  • Fax: 713-704-7150
Mailing address:
  • Phone: 504-340-6976
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberBP10053027
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: