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General NPI Number Information
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NPI Number | 1871552869
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Entity Type | Individual
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Provider Name | CHAD E LEWIS MD
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Gender | Male
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Dates
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Enumeration Date | 03/20/2006
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Last Update Date | 10/06/2020
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Provider Practice Location Address
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Address Line | 1617 4TH AVE
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City | CANYON
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State | TX
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Zip | 79015-3824
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Country | US
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Telephone | 806-452-7221
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Fax | 806-452-7231
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Provider Business Mailing Address
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Address Line | 2200 4TH AVE # 207
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City | CANYON
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State | TX
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Zip | 79015-4030
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Country | US
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Telephone | 806-452-7221
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Fax | 806-452-7231
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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 | MD203738
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | M0150
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 49193
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License Number State | TN
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Taxonomy #4
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Taxonomy Code | 208C00000X
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Taxonomy Name | Colon & Rectal Surgery Physician
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License Number | MD203738
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License Number State | LA
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Taxonomy #5
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Taxonomy Code | 208C00000X
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Taxonomy Name | Colon & Rectal Surgery Physician
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License Number | 49193
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License Number State | TN
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Taxonomy #6
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Taxonomy Code | 208C00000X
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Taxonomy Name | Colon & Rectal Surgery Physician
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License Number | M0150
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License Number State | TX
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