Organization
KEVIN E. LEW, DDS, MD, PLLC
Active
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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