Provider Demographics
NPI:1235001033
Name:LEWIS, IMARA SEREN (BS, MBA)
Entity type:Individual
Prefix:MRS
First Name:IMARA
Middle Name:SEREN
Last Name:LEWIS
Suffix:
Gender:F
Credentials:BS, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 GREENWAY PLZ STE 1800
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77046-2457
Mailing Address - Country:US
Mailing Address - Phone:713-969-5012
Mailing Address - Fax:
Practice Address - Street 1:24 GREENWAY PLZ STE 1800
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77046-2457
Practice Address - Country:US
Practice Address - Phone:713-969-5012
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-22
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician