Individual
DR. LARRY L LEWELLYN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4007 JAMES CASEY ST, SUITE A150, AUSTIN, TX 78745-3369
(512) 447-0707
Mailing address
4007 JAMES CASEY ST, SUITE A150, AUSTIN, TX 78745-3369
(512) 447-0707
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
G4336
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
127141301
—
TX
Enumeration date
02/27/2006
Last updated
09/20/2011
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