Organization
DERI M LEWIS MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DERI M LEWIS MD PA (OWNER)
(972) 566-5880
Entity
Organization
Contact information
Practice address
7777 FOREST LN, C522, DALLAS, TX 75230-2505
(972) 566-5880
Mailing address
7777 FOREST LN, C522, DALLAS, TX 75230-2505
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
M4289
TX
Other
Enumeration date
12/01/2009
Last updated
12/01/2009
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