=====================================================
General NPI Number Information
=====================================================
NPI Number | 1669603908
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | INTERNAL DIRECTIONS INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/04/2009
-----------------------------------------------------
Last Update Date | 08/04/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9896 BISSONNET ST 570
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77036-8104
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-223-0190
-----------------------------------------------------
Fax | 713-223-0191
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9896 BISSONNET ST 570
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77036-8104
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-223-0190
-----------------------------------------------------
Fax | 713-223-0191
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/CEO
-----------------------------------------------------
Name | DR. ROBERT IRA LEWY
-----------------------------------------------------
Credential | M D
-----------------------------------------------------
Telephone | 713-223-0190
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | GFE30070
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------