Charles Turner Lewis III, M.D.
Individual provider Active NPI Pediatrics Physician · Kaufman, TX
NPI 1962406744 · NPPES record last updated May 30, 2013
Key facts
- NPI
- 1962406744
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- J0770 (TX)
- Practice address
- 1011 W Grove St
Ste 100
Kaufman, TX 75142-1827 - Phone
- (972) 932-1319
- Fax
- (972) 932-1388
- NPI assigned
- Jun 9, 2005
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| J0770 | TX | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advantage Health Services | Pediatrics | Current | Accepting new patients |
| Total Care Pediatrics, PA | Pediatrics | Past | Accepting new patients |
| Lone Star Pediatrics, PA | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- charleslewis@cmcet.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | J0770 | TX | Yes |
Addresses
Primary practice location
1011 W Grove St
Ste 100
Kaufman, TX 75142-1827
Mailing address
1011 W Grove St
Ste 100
Kaufman, TX 75142-1827
Phone (972) 932-1319
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 121232603 | Medicaid | TX | |
| 752551507 | Other | TX | TAX ID |
| 121232601 | Medicaid | TX |
Other providers in Kaufman, TX
- Brandie Law
- Frances Charline Lee Cole
- Keyna Lee
- Paloma Leos
- Romie Letlow
- Janet Robertson Lewis
- Linda J Jennings Inc
- Carl Dwayne Linn Jr.
- Lone Star Pediatrics, PA
- Lotus RX Inc
All providers in Kaufman, TX · Pediatrics Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 30, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.