Provider Demographics
NPI:1164240784
Name:LEVY ENTERPRISE LLC
Entity type:Organization
Organization Name:LEVY ENTERPRISE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CRANIAL PROSTHESIS SPECIALIST
Authorized Official - Prefix:MS
Authorized Official - First Name:A'RAVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:SPECIALIST
Authorized Official - Phone:404-647-3038
Mailing Address - Street 1:1807 EWING ST APT 10A
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-7334
Mailing Address - Country:US
Mailing Address - Phone:404-647-3038
Mailing Address - Fax:
Practice Address - Street 1:440 LOUISIANA ST STE 900
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-1062
Practice Address - Country:US
Practice Address - Phone:866-577-2267
Practice Address - Fax:713-250-8667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-02
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No1744P3200XOther Service ProvidersSpecialistProsthetics Case ManagementGroup - Multi-Specialty