Provider Demographics
NPI:1609060656
Name:FELICIA R. LEWIS
Entity Type:Organization
Organization Name:FELICIA R. LEWIS
Other - Org Name:TLC PERSONAL CARE PROVIDERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:FELICIA
Authorized Official - Middle Name:RENA
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:832-283-6912
Mailing Address - Street 1:811 DERBY LN
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77489-3259
Mailing Address - Country:US
Mailing Address - Phone:832-283-6912
Mailing Address - Fax:281-416-0114
Practice Address - Street 1:811 DERBY LN
Practice Address - Street 2:SUITE 200
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77489-3259
Practice Address - Country:US
Practice Address - Phone:832-283-6912
Practice Address - Fax:281-416-0114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-04
Last Update Date:2009-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX178323164X00000X, 251J00000X
TX12791971347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164X00000XNursing Service ProvidersLicensed Vocational NurseGroup - Single Specialty
No251J00000XAgenciesNursing Care
No347C00000XTransportation ServicesPrivate VehicleGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX626197482OtherDUNS