Provider Demographics
NPI:1487088928
Name:TRUSTED COMPASSIONATE PHYSICIAN
Entity type:Organization
Organization Name:TRUSTED COMPASSIONATE PHYSICIAN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JIMMIE
Authorized Official - Middle Name:EARL
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:832-687-0282
Mailing Address - Street 1:5205 S MASON RD
Mailing Address - Street 2:SUITE 210 PMB M-2
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-7138
Mailing Address - Country:US
Mailing Address - Phone:832-687-0282
Mailing Address - Fax:832-803-4792
Practice Address - Street 1:5205 S MASON RD
Practice Address - Street 2:SUITE 210 PMB M-2
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-7138
Practice Address - Country:US
Practice Address - Phone:832-687-0282
Practice Address - Fax:832-803-4792
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-31
Last Update Date:2013-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty