Provider Demographics
NPI:1326373838
Name:LEWIS EYE CARE PLLC
Entity Type:Organization
Organization Name:LEWIS EYE CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:WESLEY
Authorized Official - Middle Name:D
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:540-977-2380
Mailing Address - Street 1:4524 CHALLENGER AVE
Mailing Address - Street 2:ATTN: DR. LEWIS
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24012-7028
Mailing Address - Country:US
Mailing Address - Phone:540-977-2380
Mailing Address - Fax:540-977-2381
Practice Address - Street 1:4524 CHALLENGER AVE
Practice Address - Street 2:ATTN: DR. LEWIS
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24012-7028
Practice Address - Country:US
Practice Address - Phone:540-977-2380
Practice Address - Fax:540-977-2381
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-16
Last Update Date:2009-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618001884152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty