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Organization
VITALITY CENTER
Active
Organization
VITALITY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HARRISON LEWIS PA (PHYSICIAN ASSISTANT)
(214) 415-9334
Entity
Organization
Contact information
Practice address
14444 EASTSIDE RD, TYLER, TX 75707-6724
(214) 415-9334
Mailing address
14444 EASTSIDE DR., TYLER, TX 75707
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA03127
TX
Other
Enumeration date
01/18/2013
Last updated
01/18/2013
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