Individual
LISA E LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6618 FOSSIL BLUFF DR, STE 116, FORT WORTH, TX 76137-7533
(817) 847-6420
(817) 847-6412
Mailing address
230 N RUFE SNOW DR, KELLER, TX 76248-4226
(817) 337-5503
(817) 337-0110
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
K0730
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0046KV
BCBS GROUP
TX
05
—
047946102
—
TX
01
—
1164541967
FORT WORTH GROUP NPI
—
01
—
1710006598
KELLER GROUP NPI
—
01
—
8K6666
BCBS
TX
Enumeration date
10/10/2006
Last updated
03/31/2009
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