Provider Demographics
NPI:1053675736
Name:EC LEWISVILLE, LLC
Entity Type:Organization
Organization Name:EC LEWISVILLE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:SEAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-784-1500
Mailing Address - Street 1:211 HIGHLAND CROSS DR
Mailing Address - Street 2:SUITE 275
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77073-1733
Mailing Address - Country:US
Mailing Address - Phone:281-784-1500
Mailing Address - Fax:281-784-1653
Practice Address - Street 1:4780 SH 121
Practice Address - Street 2:
Practice Address - City:THE COLONY
Practice Address - State:TX
Practice Address - Zip Code:75056-2913
Practice Address - Country:US
Practice Address - Phone:281-784-1500
Practice Address - Fax:281-784-1653
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-27
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX160063261QE0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXHH069EOtherBCBSTX