Basic Information
| Provider Information | |||||||||
| NPI: | 1558541656 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PAULA LEWIS DO, PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 560993 | ||||||||
| Address2: | |||||||||
| City: | THE COLONY | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750560993 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9726687460 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7992 W VIRGINIA DR | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752373764 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9726687460 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/06/2007 | ||||||||
| LastUpdateDate: | 09/16/2008 | ||||||||
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| AuthorizedOfficialLastName: | LEWIS | ||||||||
| AuthorizedOfficialFirstName: | PAULA | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 9726687460 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | DO | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | H3794 | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 163709201 | 05 | TX | MEDICAID |