MEDICARE: DAVID R LEWIS DDS PA

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	1223G0001X	General Practice Dentistry	16362	TX

General Provider Information

NPI Number	:	1508964594
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAVID R LEWIS DDS PA

Provider Business Mailing Address
First Line	:	14603 HUEBNER RD
Second Line	:	SUITE 3501
City	:	SAN ANTONIO
State	:	TX
Zip	:	78230
Country	:	US
Telephone Number	:	210-344-5754
Fax Number	:	210-377-2034

Provider Business Practice Location Address
First Line	:	14603 HUEBNER RD
Second Line	:	SUITE 3501
City	:	SAN ANTONIO
State	:	TX
Zip	:	78230
Country	:	US
Telephone Number	:	210-344-5754
Fax Number	:	210-377-2034

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DAVID ROBERT LEWIS
Credential	:	DDS
Telephone Number	:	210-344-5754

Provider Enumeration Date	:	09/21/2006
Last Update Date	:	07/21/2022

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