Provider Demographics
NPI:1144937210
Name:LEWIS, CARLTON (LAC, MD, DACM)
Entity type:Individual
Prefix:DR
First Name:CARLTON
Middle Name:
Last Name:LEWIS
Suffix:
Gender:M
Credentials:LAC, MD, DACM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5907 WINTER BREEZE DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-5551
Mailing Address - Country:US
Mailing Address - Phone:713-540-6136
Mailing Address - Fax:
Practice Address - Street 1:9595 SIX PINES DR STE 8210
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-1642
Practice Address - Country:US
Practice Address - Phone:832-631-6300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-28
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171400000X, 174H00000X
TXACO2010171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No171400000XOther Service ProvidersHealth & Wellness Coach
No174H00000XOther Service ProvidersHealth Educator