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General NPI Number Information
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NPI Number | 1528674843
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Entity Type | Individual
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Provider Name | CHELSEA LEWIS RDMS, RVT
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Gender | Female
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Dates
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Enumeration Date | 09/22/2020
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Last Update Date | 09/22/2020
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Provider Practice Location Address
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Address Line | 1014 FM 226
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City | NACOGDOCHES
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State | TX
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Zip | 75961-6632
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Country | US
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Telephone | 936-657-0030
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Fax |
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Provider Business Mailing Address
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Address Line | 1014 FM 226
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City | NACOGDOCHES
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State | TX
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Zip | 75961-6632
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Country | US
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Telephone | 936-657-0030
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Fax |
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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 | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number | 182980
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License Number State | TX
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