Provider Demographics
NPI:1093746588
Name:LEVY, BRUCE A (MD, JD)
Entity Type:Individual
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First Name:BRUCE
Middle Name:A
Last Name:LEVY
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Gender:M
Credentials:MD, JD
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Mailing Address - Street 1:5801 WESTSLOPE CV
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-3656
Mailing Address - Country:US
Mailing Address - Phone:512-420-0186
Mailing Address - Fax:512-420-0397
Practice Address - Street 1:8217 SHOAL CREEK BLVD
Practice Address - Street 2:102
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78757-7560
Practice Address - Country:US
Practice Address - Phone:512-420-0186
Practice Address - Fax:512-420-0397
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
TXF7513207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC18376Medicare UPIN