Individual
JACK BYRON LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
252 MATLOCK RD STE 244, MANSFIELD, TX 76063-4294
(817) 784-8268
(817) 477-8881
Mailing address
252 MATLOCK RD STE 244, MANSFIELD, TX 76063-4294
(817) 784-8268
(817) 477-8881
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
43653-020
WI
208800000X
Urology Physician
Primary
MD28015
OR
Other
Enumeration date
03/29/2006
Last updated
05/07/2024
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