Provider Demographics
NPI:1962829861
Name:FELICIA R. LEWIS
Entity Type:Organization
Organization Name:FELICIA R. LEWIS
Other - Org Name:PRECISION PHLEBOTOMY & SPECIMEN COLLECTION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
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:
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:
Practice Address - Street 1:811 DERBY LN
Practice Address - Street 2:
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:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-28
Last Update Date:2014-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX178323251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX178323OtherLICENSE