Healthcare Provider Details

I. General information

NPI: 1568641488
Provider Name (Legal Business Name): LEWIS-BRYANT TRANSPORTATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2007
Last Update Date: 10/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11825 LONGWOOD GARDEN WAY
HOUSTON TX
77047-4435
US

IV. Provider business mailing address

11825 LONGWOOD GARDEN WAY
HOUSTON TX
77047-4435
US

V. Phone/Fax

Practice location:
  • Phone: 832-207-2363
  • Fax: 713-862-4913
Mailing address:
  • Phone: 832-207-2363
  • Fax: 713-862-4913

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MRS. LYDIA M LEWIS
Title or Position: PRESIDENT/PROGRAM MANAGER
Credential:
Phone: 832-207-2363