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NPI Code Detail

MEDICARE: DR. VELISSA A LEWIS D.P.M.

MEDICARE: DR. VELISSA A LEWIS D.P.M.
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
1213ES0103XFoot & Ankle Surgery Podiatrist1571TX
2213E00000XPodiatrist1571TX

General Provider Information

NPI Number : 1669408407
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. VELISSA A LEWIS D.P.M.
Provider Business Mailing Address
First Line : 809 SINGLETON BLVD
Second Line :
City : DALLAS
State : TX
Zip : 75212-4014
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 809 SINGLETON BLVD
Second Line :
City : DALLAS
State : TX
Zip : 75212-4014
Country : US
Telephone Number : 214-540-0300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2006
Last Update Date : 08/28/2017

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