Provider Demographics
NPI:1083628804
Name:LEWIS AND ASSOCIATES, DDS, PC
Entity Type:Organization
Organization Name:LEWIS AND ASSOCIATES, DDS, PC
Other - Org Name:SOUTHERN DENTAL ASSOCIATES - DEERBROOK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:D
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:713-681-7920
Mailing Address - Street 1:2500 CENTRAL PKWY
Mailing Address - Street 2:SUITE P
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77092-7733
Mailing Address - Country:US
Mailing Address - Phone:713-681-7920
Mailing Address - Fax:713-263-0132
Practice Address - Street 1:1238 DEERBROOK MALL
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338
Practice Address - Country:US
Practice Address - Phone:281-446-9687
Practice Address - Fax:281-446-6942
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2009-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9517122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty