Provider Demographics
NPI:1295028553
Name:LEWIS, CAROL WEST (NP - FNP)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:WEST
Last Name:LEWIS
Suffix:
Gender:F
Credentials:NP - FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5210 NEWCOME DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-4927
Mailing Address - Country:US
Mailing Address - Phone:210-680-4947
Mailing Address - Fax:210-680-4947
Practice Address - Street 1:5210 NEWCOME DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4927
Practice Address - Country:US
Practice Address - Phone:210-680-4947
Practice Address - Fax:210-680-4947
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-19
Last Update Date:2011-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX220274363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily