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Individual

LEWIS R. KING

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
802 HOPKINS ST, GARLAND HEALTH CENTER, GARLAND, TX 75040-7379
(214) 266-0700
(214) 266-0656
Mailing address
PO BOX 660599, DALLAS, TX 75266-0599

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
J5377
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
139131001
TX
05
139131002
TX
05
139131004
TX
05
139131005
TX
05
139131006
TX
05
139131007
TX
05
139131008
TX
05
139131009
TX
05
139131010
TX
05
139131012
TX
05
139131013
TX
05
139131014
TX
05
139131016
TX
01
89G964
BLUE CROSS BLUE SHIELD
TX
Enumeration date
11/30/2005
Last updated
12/06/2012
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