MEDICARE: KAY R 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
1	2084P0804X	Child & Adolescent Psychiatry Physician	D5775	TX
2	101YP2500X	Professional Counselor

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	260037033	OTHER	TX	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	86804J	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1447278668
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAY R LEWIS M.D.

Provider Business Mailing Address
First Line	:	15 GREENWAY PLZ UNIT 20J
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77046-1506
Country	:	US
Telephone Number	:	281-543-9458
Fax Number	:

Provider Business Practice Location Address
First Line	:	15 GREENWAY PLZ UNIT 20J
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77046-1506
Country	:	US
Telephone Number	:	281-543-9458
Fax Number	:

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

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	07/09/2019

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