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NPI Code Detail

MEDICARE: TIMOTHY A LEWIS CRNA

MEDICARE: TIMOTHY A LEWIS CRNA
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
1367500000XCertified Registered Nurse Anesthetist714478TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
185804UOTHERTXBCBSTX

General Provider Information

NPI Number : 1306820469
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIMOTHY A LEWIS CRNA
Provider Business Mailing Address
First Line : 6126 GARDEN CT
Second Line :
City : CORPUS CHRISTI
State : TX
Zip : 78414-6071
Country : US
Telephone Number : 361-452-0165
Fax Number :
Provider Business Practice Location Address
First Line : 600 ELIZABETH ST
Second Line :
City : CORPUS CHRISTI
State : TX
Zip : 78404-2235
Country : US
Telephone Number : 361-881-3651
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2005
Last Update Date : 10/26/2007

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Directions to “ TIMOTHY A LEWIS CRNA” Practice Location

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