Active NPI
Rico Lewis Jr., CCP
- Perfusionist
- Houston, TX
National Provider Identifier
1568113108
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Perfusionist
- License
- FPF00001203
- Practice address
- 17581 Red Oak Dr
Houston, TX 77090-1247 - Phone
- (360) 250-0367
- NPI assigned
- Jan 14, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Perfusionist | 242T00000X | FPF00001203 | TX | Primary |
Addresses
Primary practice location
17581 Red Oak Dr
Houston, TX 77090-1247
Mailing address
209 W 2ND St Unit 152
Fort Worth, TX 76102-3021
Phone (360) 250-0367
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| FPF00001203 | TX | MD | Perfusionist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1642118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642118400000",
"number": "1568113108",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "209 W 2ND ST UNIT 152",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761023021",
"telephone_number": "360-250-0367"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17581 RED OAK DR",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770901247",
"telephone_number": "360-250-0367"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEWIS",
"first_name": "RICO",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "CCP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-01-14",
"last_updated": "2022-01-14",
"certification_date": "2022-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "242T00000X",
"taxonomy_group": "",
"desc": "Perfusionist",
"state": "TX",
"license": "FPF00001203",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.