Provider Demographics
NPI:1750856936
Name:LEWIS, TERESA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:TERESA
Middle Name:
Last Name:LEWIS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:TERESA
Other - Middle Name:
Other - Last Name:PALMER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:19211 BULLARD CREEK DR
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-5214
Mailing Address - Country:US
Mailing Address - Phone:304-942-8410
Mailing Address - Fax:
Practice Address - Street 1:19211 BULLARD CREEK DR
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-5214
Practice Address - Country:US
Practice Address - Phone:304-942-8410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-03
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX59450208U00000X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No208U00000XAllopathic & Osteopathic PhysiciansClinical Pharmacology