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NPI Code Detail

MEDICARE: KIMBERLY LEWIS

MEDICARE: KIMBERLY LEWIS
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
1225200000XPhysical Therapy Assistant2058640TX

General Provider Information

NPI Number : 1538649314
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY LEWIS
Provider Business Mailing Address
First Line : 3800 COUNTY ROAD 94 APT 6304
Second Line :
City : MANVEL
State : TX
Zip : 77578-2967
Country : US
Telephone Number : 832-878-1522
Fax Number :
Provider Business Practice Location Address
First Line : 3434 WATTERS RD
Second Line :
City : PASADENA
State : TX
Zip : 77504-2015
Country : US
Telephone Number : 713-941-9155
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/21/2018
Last Update Date : 08/21/2018

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Directions to “ KIMBERLY LEWIS ” Practice Location

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