Provider Demographics
NPI:1184007460
Name:LEVY, BRANDON (MD)
Entity Type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:
Last Name:LEVY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 W MAYFIELD RD STE 118
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76014-2084
Mailing Address - Country:US
Mailing Address - Phone:877-314-8990
Mailing Address - Fax:833-794-3342
Practice Address - Street 1:515 W MAYFIELD RD STE 118
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76014-2084
Practice Address - Country:US
Practice Address - Phone:877-314-8990
Practice Address - Fax:833-794-3342
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-03
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX592921208600000X
390200000X
TXT5608207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program