Provider Demographics
NPI:1144523291
Name:LEWIS, BILLY WAYNE (MD)
Entity type:Individual
Prefix:MR
First Name:BILLY
Middle Name:WAYNE
Last Name:LEWIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:12900 PRESTON RD.
Mailing Address - Street 2:SUITE 1200
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-1353
Mailing Address - Country:US
Mailing Address - Phone:972-480-0000
Mailing Address - Fax:972-960-6097
Practice Address - Street 1:12900 PRESTON RD.
Practice Address - Street 2:SUITE 12000
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-1353
Practice Address - Country:US
Practice Address - Phone:972-480-0000
Practice Address - Fax:972-960-6097
Is Sole Proprietor?:No
Enumeration Date:2010-12-13
Last Update Date:2010-12-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXD7149207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC18410Medicare UPIN