MEDICARE: TYLER LEWIS DC

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	111N00000X	Chiropractor	13261	TX

General Provider Information

NPI Number	:	1154830867
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TYLER LEWIS DC

Provider Business Mailing Address
First Line	:	6600 LBJ FWY STE 125
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75240-6514
Country	:	US
Telephone Number	:	972-854-3256
Fax Number	:

Provider Business Practice Location Address
First Line	:	6600 LBJ FWY STE 125
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75240-6514
Country	:	US
Telephone Number	:	972-854-3256
Fax Number	:

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

Provider Enumeration Date	:	09/26/2017
Last Update Date	:	07/21/2022

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Directions to “ TYLER LEWIS DC” Practice Location

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