Provider Demographics
NPI:1578569976
Name:LEWIS, HARRY MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:HARRY
Middle Name:MICHAEL
Last Name:LEWIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:707 LAMAR AVE
Mailing Address - Street 2:STE C2
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75460-4460
Mailing Address - Country:US
Mailing Address - Phone:903-784-0878
Mailing Address - Fax:903-784-8220
Practice Address - Street 1:707 LAMAR AVE
Practice Address - Street 2:STE C2
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75460-4460
Practice Address - Country:US
Practice Address - Phone:903-784-0878
Practice Address - Fax:903-784-8220
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-22
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ0989208G00000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0986820-01Medicaid
OK200038860AMedicaid
TX00H16JMedicare PIN
C43455Medicare UPIN