Organization Active NPI

Beverly Guillory Lewis MD, PA

  • Surgery Physician
  • Galveston, TX
National Provider Identifier
1275723249
Registry record updated Apr 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
F4211 Issued in TX
Legal business name
BEVERLY GUILLORY LEWIS MD, PA
Practice address
1021 61St St
#210
Galveston, TX 77550-0000
Phone
(409) 740-2700
NPI assigned
Jul 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Dennice M. Watkins
Title
Office Manager
Phone
(409) 945-0810

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X F4211 TX Primary

Addresses

Primary practice location

1021 61St St
#210
Galveston, TX 77550-0000

Mailing address

1228 N Logan St
Ste 200
Texas City, TX 77590-5171
Phone (409) 945-0810

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060425000229 TX Part B Supplier - Clinic/Group Practice 7719997550 Receives reassigned benefits from 1 practitioner
Practice locations: Texas City, TX

National Provider Directory

National Provider Directory

Locations

1021 61st St
#210
Galveston, TX 77551
Phone (409) 740-2700

1228 N Logan St
Ste 200
Texas City, TX 77590
Phone (409) 945-0810

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1185408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207180800000",
    "number": "1275723249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1228 N LOGAN ST",
            "address_2": "STE 200",
            "city": "TEXAS CITY",
            "state": "TX",
            "postal_code": "775905171",
            "telephone_number": "409-945-0810",
            "fax_number": "409-945-6678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 61ST ST",
            "address_2": "#210",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775500000",
            "telephone_number": "409-740-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEVERLY GUILLORY LEWIS MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-26",
        "last_updated": "2008-04-03",
        "status": "A",
        "authorized_official_last_name": "WATKINS",
        "authorized_official_first_name": "DENNICE",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "409-945-0810",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "TX",
            "license": "F4211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galveston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.