Provider Demographics
NPI:1972524098
Name:LEWIS PINCUS, DO, PA
Entity Type:Organization
Organization Name:LEWIS PINCUS, DO, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LEWIS
Authorized Official - Middle Name:
Authorized Official - Last Name:PINCUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-298-3972
Mailing Address - Street 1:3450 W WHEATLAND RD
Mailing Address - Street 2:BUILDING 1, SUITE 211
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75237-3470
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3450 W WHEATLAND RD
Practice Address - Street 2:BUILDING 1, SUITE 211
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75237-3470
Practice Address - Country:US
Practice Address - Phone:972-298-3972
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXCS8976OtherMEDICARE RAILROAD
TX00H40EOtherBCBS
TX00H40EMedicare ID - Type Unspecified