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Organization
A RAY LEWIS, DO, PLLC
Active
Organization
A RAY LEWIS, DO, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ADOLPHUS RAY LEWIS DO (OWNER/PHYSICIAN)
(817) 413-0943
Entity
Organization
Contact information
Practice address
4732 E LANCASTER AVE STE A, FORT WORTH, TX 76103-3836
(817) 413-0943
(817) 413-0300
Mailing address
4732 E LANCASTER AVE STE A, FORT WORTH, TX 76103-3836
(817) 413-0943
(817) 413-0300
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0068TD
BLUE CROSS BLUE SHIELD
TX
05
—
2166936-01
—
TX
05
—
2166985-01
—
TX
01
—
DQ6866
PALMETTO GBA RAILROAD MEDICARE
TX
Enumeration date
02/01/2010
Last updated
05/26/2015
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