| Organization Name: | WEATHERFORD PODIATRY CLINICS, P.A. |
| NPI Number: | 1124205158 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | WAYMON EDWARD LEWIS (PHYSICIAN) |
| Mailing Address: | 925 Santa Fe Dr Suite 110 Weatherford |
| State: | TX US |
| Postal Code: | 760865866 |
| Phone Number: | 8173413901 |
| Fax Number: | 8175997018 |
| NPI Enumeration Date: | 01/22/2008 |
| NPI Last Update Date: | 01/20/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | 1477 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |