Provider Demographics
NPI:1982637831
Name:LEWIS, ADAM I (MD)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:I
Last Name:LEWIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1020 RIVERWOOD CT STE 305
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-2974
Mailing Address - Country:US
Mailing Address - Phone:832-447-7494
Mailing Address - Fax:832-510-0563
Practice Address - Street 1:7121 S PADRE ISLAND DR STE 106
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78412-4939
Practice Address - Country:US
Practice Address - Phone:361-561-9560
Practice Address - Fax:361-561-9563
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2025-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXU7124207T00000X, 207T00000X
FLME125571207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS0120069Medicaid
MS140000117Medicare ID - Type Unspecified
G28405Medicare UPIN