Individual
DR. KELLY FULLER LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3041 CHURCHILL DR STE 300, FLOWER MOUND, TX 75022
(972) 691-1240
(972) 691-2073
Mailing address
3041 CHURCHILL DR STE 300, FLOWER MOUND, TX 75022-5906
(972) 691-1240
(972) 691-2073
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
R7519
TX
Other
Enumeration date
06/09/2015
Last updated
10/01/2018
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