Provider Demographics
NPI:1922195791
Name:LANDSMAN, LEWIS A II (PA)
Entity Type:Individual
Prefix:
First Name:LEWIS
Middle Name:A
Last Name:LANDSMAN
Suffix:II
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 FM 1764 RD
Mailing Address - Street 2:STE 190
Mailing Address - City:LA MARQUE
Mailing Address - State:TX
Mailing Address - Zip Code:77568-2826
Mailing Address - Country:US
Mailing Address - Phone:281-886-8964
Mailing Address - Fax:409-440-8071
Practice Address - Street 1:2808 61ST ST STE 200
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77551-2224
Practice Address - Country:US
Practice Address - Phone:281-886-8964
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA02821363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXDD5409OtherRAILROAD MEDICARE GROUP
TXPA02821OtherPHYSICIAN ASST
TX8Y2310OtherBCBS INDIVIDUAL
TXDD5409OtherRAILROAD MEDICARE GROUP
TXPA02821OtherPHYSICIAN ASST