Organization
KEVIN E. LEW, DDS, MD, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN EDWARD LEW DDS, MD (PRESIDENT)
(213) 864-7670
Entity
Organization
Contact information
Practice address
6701 RIALTO BLVD APT 2202, AUSTIN, TX 78735-8597
(512) 828-3128
Mailing address
6705 W HIGHWAY 290 STE 502-273, AUSTIN, TX 78735-8400
(213) 864-7670
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3204324
INDIVIDUAL NUMBER
TX
01
—
38024
DDS LICENSE
TX
Enumeration date
07/23/2022
Last updated
03/07/2023
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