Individual
KATHRYN MARIE LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4920 N.E. STALLILNGS DRIVE, NACOGDOCHES, TX 75961
(936) 568-3493
(281) 548-3513
Mailing address
PO BOX 6325, HUMBLE, TX 77325-6325
(281) 360-5400
(281) 548-3513
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
H0564
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
032010301
—
TX
Enumeration date
08/31/2005
Last updated
11/16/2007
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