Individual
DR. CHARLA LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
3025 E RENNER RD STE 303, RICHARDSON, TX 75082-3580
(713) 457-4372
(713) 457-0945
Mailing address
6315 GULFTON ST STE 100, HOUSTON, TX 77081-1107
(713) 457-4372
(469) 294-9175
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
04586
MD
103T00000X
Psychologist
1000544
DC
103T00000X
Psychologist
Primary
38413
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
037904200
—
MD
01
—
1A6905
MEDICARE
—
05
—
408966601
—
TX
Enumeration date
12/08/2010
Last updated
06/23/2021
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