Provider Demographics
NPI:1346004884
Name:LEWIS, DEVYA TRENISE (CERTIFIED PHLEB)
Entity Type:Individual
Prefix:
First Name:DEVYA
Middle Name:TRENISE
Last Name:LEWIS
Suffix:
Gender:F
Credentials:CERTIFIED PHLEB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:719 SCOTT AVE STE 508
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76301-2631
Mailing Address - Country:US
Mailing Address - Phone:940-228-4636
Mailing Address - Fax:
Practice Address - Street 1:719 SCOTT AVE STE 508
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76301-2631
Practice Address - Country:US
Practice Address - Phone:940-228-4636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-06
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX658-10024246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy