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General NPI Number Information
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NPI Number | 1356425227
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Entity Type | Individual
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Provider Name | BEVERLY GUILLORY LEWIS MD
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Gender | Female
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 10/01/2013
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Provider Practice Location Address
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Address Line | 1021 61ST ST # 210
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City | GALVESTON
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State | TX
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Zip | 77551-0000
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Country | US
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Telephone | 409-740-2700
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Fax |
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Provider Business Mailing Address
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Address Line | 1228 LOGAN STE 200
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City | TEXAS CITY
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State | TX
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Zip | 77590
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Country | US
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Telephone | 409-945-0810
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Fax | 409-945-6678
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | F4211
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License Number State | TX
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