Individual
LEWIS R. KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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
Update your record
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