Provider Demographics
NPI:1902959380
Name:DAVID S LEVEY MD PA
Entity Type:Organization
Organization Name:DAVID S LEVEY MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RADIOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:STANLEY
Authorized Official - Last Name:LEVEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-492-0050
Mailing Address - Street 1:622 CINNAMON OAK
Mailing Address - Street 2:
Mailing Address - City:SHAVANO PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78230-5649
Mailing Address - Country:US
Mailing Address - Phone:210-492-0050
Mailing Address - Fax:210-492-0060
Practice Address - Street 1:622 CINNAMON OAK
Practice Address - Street 2:
Practice Address - City:SHAVANO PARK
Practice Address - State:TX
Practice Address - Zip Code:78230-5649
Practice Address - Country:US
Practice Address - Phone:210-492-0050
Practice Address - Fax:210-492-0060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2010-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTX J4892261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX119324508Medicaid
TX611381Medicare PIN
TXF58726Medicare UPIN