Provider Demographics
NPI:1750442083
Name:LEWIS, KAMALA ANN (DDS)
Entity type:Individual
Prefix:DR
First Name:KAMALA
Middle Name:ANN
Last Name:LEWIS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 E PIERCE ST
Mailing Address - Street 2:
Mailing Address - City:LULING
Mailing Address - State:TX
Mailing Address - Zip Code:78648-2613
Mailing Address - Country:US
Mailing Address - Phone:830-875-2056
Mailing Address - Fax:830-875-2095
Practice Address - Street 1:508 E PIERCE ST
Practice Address - Street 2:
Practice Address - City:LULING
Practice Address - State:TX
Practice Address - Zip Code:78648-2613
Practice Address - Country:US
Practice Address - Phone:830-875-2056
Practice Address - Fax:830-875-2095
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18064122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist