Organization
LEWIS PODIATRY GROUP PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRANDON J LEWIS DPM (PRESIDENT)
(972) 263-7042
Entity
Organization
Contact information
Practice address
504 N CARRIER PKWY, GRAND PRAIRIE, TX 75050-5428
(973) 263-7042
(972) 263-7046
Mailing address
504 N CARRIER PKWY, GRAND PRAIRIE, TX 75050-5428
(973) 263-7042
(972) 263-7046
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
1574
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0006NH
BCBS
TX
05
—
180094801
—
TX
Enumeration date
04/26/2007
Last updated
05/06/2008
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