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Individual

MR. RICO LEWIS JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CCP

Contact information

Practice address
17581 RED OAK DR, HOUSTON, TX 77090-1247
(360) 250-0367
Mailing address
209 W 2ND ST UNIT 152, FORT WORTH, TX 76102-3021
(360) 250-0367

Taxonomy

Speciality
Code
Description
License number
State
242T00000X
Perfusionist
Primary
FPF00001203
TX

Other

Enumeration date
01/14/2022
Last updated
01/14/2022
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