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NPI Code Detail

MEDICARE: DR. DIANE LYNNETTE LEWIS M.D.

MEDICARE: DR. DIANE LYNNETTE LEWIS M.D.
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
12084P0800XPsychiatry PhysicianP4670TX
22084P0800XPsychiatry Physician316592NY

General Provider Information

NPI Number : 1306073606
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DIANE LYNNETTE LEWIS M.D.
Provider Business Mailing Address
First Line : 1701 S BELL BLVD APT 903
Second Line :
City : CEDAR PARK
State : TX
Zip : 78613-2180
Country : US
Telephone Number : 795-955-8269
Fax Number :
Provider Business Practice Location Address
First Line : 1400 N COIT RD STE 302
Second Line :
City : MCKINNEY
State : TX
Zip : 75071-6656
Country : US
Telephone Number : 917-634-5311
Fax Number : 888-815-3583
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2009
Last Update Date : 07/01/2024

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