Individual
WALTER O LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1802 DYNASTY DR, GLENN HEIGHTS, TX 75154-8634
(469) 735-1622
Mailing address
PO BOX 1968, DESOTO, TX 75123-1968
(469) 735-1622
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
10/21/2019
Last updated
10/21/2019
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