KEVIN LEWALLEN
NPI 1104551977
Physician Assistant in Fort Worth, TX

Q: What is Kevin Lewallen's NPI number?

The NPI number for Kevin Lewallen is 1104551977. It was assigned to this individual provider in the NPPES registry on July 18, 2022.

Q: What is Kevin Lewallen's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Kevin Lewallen was last updated on July 18, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 18, 2022

1301 PENNSYLVANIA AVE, FORT WORTH, TX 76104(817) 250-3152 Get Directions Write a Review

NPPES record last updated: July 18, 2022. Verified against the NPPES registry weekly; last sync: August 23, 2026.

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About Kevin Lewallen NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KEVIN LEWALLEN (NPI 1104551977) is an individual physician assistant in Fort Worth, Texas and active in the NPI registry since July 2022. He maintains a secondary practice location in Irving.

NPPES Registry Identity

NPI1104551977

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameKEVIN LEWALLEN

Location Address1301 PENNSYLVANIA AVEFort Worth, TX 76104-2122

Mailing Address4770 Regent BlvdIrving, TX 75063-2445 · (972) 891-3750 · Fax (972) 885-6494

Phone(817) 250-3152

Sole ProprietorNo

Enumeration DateJuly 18, 2022

NPPES CertifiedJuly 14, 2022

✔ NPI 1104551977 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

1301 PENNSYLVANIA AVE, Fort Worth, TX 76104

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Secondary Practice Location 1

Location 14770 Regent BlvdIrving, TX 75063-2445 · Phone (972) 891-3750 · Fax (972) 885-6494

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. HEIDI DANIELLE TOMLINSON M.D.

Pediatrics

1301 PENNSYLVANIA AVE, DEPARTMENT OF NEONATOLOGY
FORT WORTH, TX 76104

Tarrant County (817) 250-2892

RICARDO VILLARREAL JR. MD

Internal Medicine