MEDICARE: KEVIN W LEWIS D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	N3143	TX

General Provider Information

NPI Number	:	1033312426
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEVIN W LEWIS D.O.

Provider Business Mailing Address
First Line	:	13830 SAWYER RANCH RD STE 102
Second Line	:
City	:	DRIPPING SPRINGS
State	:	TX
Zip	:	78620-5514
Country	:	US
Telephone Number	:	512-301-6400
Fax Number	:	512-301-6401

Provider Business Practice Location Address
First Line	:	13830 SAWYER RANCH RD
Second Line	:	SUITE 102
City	:	DRIPPING SPRINGS
State	:	TX
Zip	:	78620-5513
Country	:	US
Telephone Number	:	512-301-6400
Fax Number	:	512-301-6401

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/06/2007
Last Update Date	:	11/06/2019

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