Provider Demographics
NPI:1811134703
Name:MERRILL SUE LEWEN MD PA
Entity type:Organization
Organization Name:MERRILL SUE LEWEN MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MERRILL
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:LEWEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-827-0300
Mailing Address - Street 1:12727 KIMBERLEY LN
Mailing Address - Street 2:#202
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-4047
Mailing Address - Country:US
Mailing Address - Phone:713-827-0300
Mailing Address - Fax:713-827-0312
Practice Address - Street 1:12727 KIMBERLEY LN
Practice Address - Street 2:#202
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-4047
Practice Address - Country:US
Practice Address - Phone:713-827-0300
Practice Address - Fax:713-827-0312
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-14
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM3298207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0075RROtherBCBS