Provider Demographics
NPI:1225216575
Name:REBECCA LEWIS
Entity Type:Organization
Organization Name:REBECCA LEWIS
Other - Org Name:BIG BEND FAMILY PRACTICE
Other - Org Type:Other Name
Authorized Official - Title/Position:FAMILY NURSE PRACTICIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:G
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:FNPC
Authorized Official - Phone:432-837-9887
Mailing Address - Street 1:803 N. 5TH
Mailing Address - Street 2:
Mailing Address - City:ALPINE
Mailing Address - State:TX
Mailing Address - Zip Code:79830
Mailing Address - Country:US
Mailing Address - Phone:432-837-9887
Mailing Address - Fax:432-837-5476
Practice Address - Street 1:803 N. 5TH
Practice Address - Street 2:
Practice Address - City:ALPINE
Practice Address - State:TX
Practice Address - Zip Code:79830
Practice Address - Country:US
Practice Address - Phone:432-837-9887
Practice Address - Fax:432-837-5476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-07
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX248736364SF0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXNP0433Medicare UPIN