Basic Information
Provider Information
NPI: 1295008571
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LEWIS-BAND
FirstName: JOSELLE
MiddleName: A.
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4502 MEDICAL DR
Address2:  
City: SAN ANTONIO
State: TX
PostalCode: 782294402
CountryCode: US
TelephoneNumber: 2105674500
FaxNumber: 2105670083
Practice Location
Address1: 4502 MEDICAL DR
Address2:  
City: SAN ANTONIO
State: TX
PostalCode: 782294402
CountryCode: US
TelephoneNumber: 2105674500
FaxNumber: 2105670083
Other Information
ProviderEnumerationDate: 02/16/2012
LastUpdateDate: 04/05/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/05/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000X074159CTN Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 
367500000X203526TXN Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 
367500000XAP136264TXY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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