Provider Demographics
NPI:1447278668
Name:LEWIS, KAY R (MD)
Entity type:Individual
Prefix:
First Name:KAY
Middle Name:R
Last Name:LEWIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 GREENWAY PLZ UNIT 20J
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77046-1506
Mailing Address - Country:US
Mailing Address - Phone:281-543-9458
Mailing Address - Fax:
Practice Address - Street 1:15 GREENWAY PLZ UNIT 20J
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77046-1506
Practice Address - Country:US
Practice Address - Phone:281-543-9458
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD57752084P0804X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX137739211Medicaid
TX260037033OtherRAILROAD MEDICARE
TX085620501Medicaid
TX86804JOtherBCBS
TXC18394Medicare UPIN
TX260037033OtherRAILROAD MEDICARE
TX085620501Medicaid