Healthcare Provider Details

I. General information

NPI: 1134238710
Provider Name (Legal Business Name): JO H LEWIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2002 HOLCOMBE BLVD
HOUSTON TX
77030-4211
US

IV. Provider business mailing address

2502 OWENS CROSS DR
HOUSTON TX
77067-3730
US

V. Phone/Fax

Practice location:
  • Phone: 173-794-1414
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2278C0205X
TaxonomyCritical Care Certified Respiratory Therapist
License Number63803
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: