Individual
JERRY MERMOD LEWIS III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8226 DOUGLAS AVE, SUITE #805, DALLAS, TX 75225-5943
(214) 373-6194
(214) 373-3404
Mailing address
4737 CROOKED LN, DALLAS, TX 75229-4212
(214) 676-4207
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
E8664
TX
Other
Enumeration date
08/20/2006
Last updated
07/08/2007
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