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Individual

DR. ADOLPHUS RAY LEWIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
4732 E LANCASTER AVE STE A, FORT WORTH, TX 76103-3836
(817) 534-1010
(817) 413-0300
Mailing address
4732 E LANCASTER AVE STE A, FORT WORTH, TX 76103-3836
(817) 534-1010
(817) 413-0300

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
H2532
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1215196-07
TX
01
8CG231
BLUE CROSS BLUE SHIELD
TX
01
P00864759
PALMETTO GBA RAILROAD MEDICARE
TX
Enumeration date
01/27/2006
Last updated
09/23/2016
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