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Austin Jerome Lewis

Internal Medicine

Allopathic & Osteopathic Physicians

4700 Alliance Blvd Ste 400, Plano, TX 75093

PECOS Enrollment

This provider is enrolled in PECOS as AUSTIN LEWIS.

Based on the most recent information from CMS, provider Austin Jerome Lewis is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 6 days ago.

Profile Details

Provider ID
1265810089
Provider Type
Individual
Full Name
Lewis, Austin Jerome
Credential
M.D.

Gender
Male
Sole Proprietor
No
Enumeration Date
5/13/2015
Last Updated
9/4/2018

Contact Information

Practice Location

4700 Alliance Blvd Ste 400, Plano, TX 75093

(469) 814-6631

(469) 814-3110

Mailing Location

4700 Alliance Blvd Ste 400, Plano, TX 75093-5323

(832) 444-8370

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License R7260 Texas
Code 390200000X	Description Student in an Organized Health Care Education/Training Program Student, Health Care	License Unlisted Issuer
Code 390200000X	Description Student in an Organized Health Care Education/Training Program Student, Health Care	License Unlisted Issuer Texas
Code 390200000X	Description Student in an Organized Health Care Education/Training Program Student, Health Care	License BP10054284 Texas

Austin Jerome Lewis

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

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