Provider Demographics
NPI:1720518996
Name:LEWANDOWSKI, EMILY R (MD)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:R
Last Name:LEWANDOWSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:R
Other - Last Name:MUNDING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1811 GREENVILLE AVE APT 3160
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-7484
Mailing Address - Country:US
Mailing Address - Phone:405-255-0096
Mailing Address - Fax:
Practice Address - Street 1:5323 HARRY HINES BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-3800
Practice Address - Country:US
Practice Address - Phone:214-648-7223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-19
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX743051208600000X
IL125071329208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery