Individual
DR. HARRISON LEWIS III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4340 FISHER RD, PROSPER, TX 75078-2602
(972) 608-3200
Mailing address
4340 FISHER RD, PROSPER, TX 75078-2602
(214) 415-9334
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085007217
IL
363AM0700X
Medical Physician Assistant
PA03127
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
342529001
—
TX
01
—
391698YMAF
MEDICARE
TX
Enumeration date
08/28/2012
Last updated
09/21/2023
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