Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | Q3226 | TX |
Y | 208600000X | Surgeon | Q3226 | TX |
N | 2086X0206X | Surgical Oncologist | Q3226 | TX |
NPI | 1285688093 |
---|---|
Provider Name | Dr. Angela Michelle Lewis-Traylor |
First Address | Humble, TX 77338-2591 |
Second Address | Humble, TX 77338-2591 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2006 |
Last Update Date | 08/03/2021 |