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General NPI Number Information
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NPI Number | 1699698001
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Entity Type | Individual
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Provider Name | FAITH GANBREL LEWIS
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Gender | Female
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Dates
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Enumeration Date | 08/03/2026
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Last Update Date | 08/03/2026
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Provider Practice Location Address
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Address Line | 450 N STANDRIDGE BLVD STE 103
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City | ANNA
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State | TX
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Zip | 75409-3443
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Country | US
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Telephone | 214-432-7733
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Fax |
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Provider Business Mailing Address
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Address Line | 91 MILES LUMBER CO RD
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City | SILVER CREEK
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State | MS
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Zip | 39663-2002
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Country | US
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Telephone | 601-455-2205
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 8234
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License Number State | TX
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