Organization
LAKE BREEZE ENT & ALLERGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROY SHELDON LEWIS M.D. (PRESIDENT)
(713) 818-0590
Entity
Organization
Contact information
Practice address
149 PLANTATION RIDGE DR, SUITE 190, MOORESVILLE, NC 28117-9174
(713) 818-0590
Mailing address
149 PLANTATION RIDGE DR, SUITE 190, MOORESVILLE, NC 28117-9174
(713) 818-0590
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
2011-01689
NC
Other
Enumeration date
03/23/2012
Last updated
03/23/2012
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