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General NPI Number Information
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NPI Number | 1558563080
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Entity Type | Organization
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Legal Business Name | CHARLES E LEWIS MD PA
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Dates
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Enumeration Date | 06/05/2007
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Last Update Date | 07/27/2007
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Provider Practice Location Address
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Address Line | 711 HILL COUNTRY DR
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City | KERRVILLE
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State | TX
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Zip | 78028-5904
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Country | US
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Telephone | 830-896-4523
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Fax | 830-896-9454
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Provider Business Mailing Address
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Address Line | 711 HILL COUNTRY DR
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City | KERRVILLE
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State | TX
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Zip | 78028-5904
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Country | US
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Telephone | 830-896-4523
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Fax | 830-896-9454
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHARLES E LEWIS
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Credential | M.D.
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Telephone | 830-896-4523
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | E4481
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License Number State | TX
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