Lewis, Brandon J.

Lewis, Brandon J. is an individual health care provider with primary practice located at 504 N Carrier Pkwy , Grand Prairie TX 75050-5428. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Lewis, Brandon J. can be contacted via phone (972) 263-7042.

Contact Information

Primary practice address
504 N Carrier Pkwy Grand Prairie TX 75050-5428
Phone: (972) 263-7042
Fax: (972) 263-7046
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 1574 Texas

Profile Details

NPI number 1487654489
LBN Legal business name Lewis, Brandon J.
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 1st, 2005
Last updated Aug 16th, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487654489 NPPES
Texas Other P00820670 GROUP MEMBER INDIVIDUAL RRM PTAN #
Texas Other 8U9330 GROUP MEMBER INDIVIDUAL RRM PTAN #
Texas MEDICAID 161998302 GROUP MEMBER INDIVIDUAL RRM PTAN #

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