# A RAY LEWIS, DO, PLLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053643130
- **Authorized official:** DR. ADOLPHUS RAY LEWIS DO (OWNER/PHYSICIAN)
- **Authorized official phone:** (817) 413-0943

## Contact information

- **Practice address:** 4732 E LANCASTER AVE STE A, FORT WORTH, TX 76103-3836
- **Practice address phone:** (817) 413-0943
- **Practice address fax:** (817) 413-0300
- **Mailing address:** 4732 E LANCASTER AVE STE A, FORT WORTH, TX 76103-3836
- **Mailing address phone:** (817) 413-0943
- **Mailing address fax:** (817) 413-0300

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/01/2010
- **Last updated:** 05/26/2015

## 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 |