Organization
IDOC VIRTUAL TELEHEALTH TEXAS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EVETTE LEWIS (PRACTICE MANAGER)
(503) 421-5124
Entity
Organization
Contact information
Practice address
2311 W MAIN ST, HOUSTON, TX 77098-3218
(713) 913-1422
(303) 922-4640
Mailing address
4635 SOUTHWEST FWY STE 525, HOUSTON, TX 77027-7157
(713) 234-4431
(877) 712-5707
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
—
2084A2900X
Neurocritical Care Physician
—
—
2279C0205X
Critical Care Registered Respiratory Therapist
—
—
Other
Enumeration date
01/31/2019
Last updated
08/21/2024
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