Provider Demographics
NPI:1225019755
Name:LEWIS HEALTH CARE FACILITY INC
Entity type:Organization
Organization Name:LEWIS HEALTH CARE FACILITY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BETTY
Authorized Official - Middle Name:LEWIS
Authorized Official - Last Name:SWABADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-354-2155
Mailing Address - Street 1:PO BOX 889
Mailing Address - Street 2:
Mailing Address - City:PORTER
Mailing Address - State:TX
Mailing Address - Zip Code:77365-0889
Mailing Address - Country:US
Mailing Address - Phone:281-354-2155
Mailing Address - Fax:281-354-6515
Practice Address - Street 1:23450 PINE SHADOW LANE
Practice Address - Street 2:
Practice Address - City:PORTER
Practice Address - State:TX
Practice Address - Zip Code:77365-0889
Practice Address - Country:US
Practice Address - Phone:281-354-2155
Practice Address - Fax:281-354-6515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDME00G318332BN1400X
1072420001332BP3500X
TX313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
Not Answered332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Not Answered313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXDME00G318OtherSTATE LICENSE #
TXDME00G318OtherSTATE LICENSE #