Provider Demographics
NPI:1326521519
Name:THORNTON, LEUWISKAH GARMON (APRN)
Entity Type:Individual
Prefix:MS
First Name:LEUWISKAH
Middle Name:GARMON
Last Name:THORNTON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:234 W CAMPBELL RD
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-3512
Mailing Address - Country:US
Mailing Address - Phone:972-474-3221
Mailing Address - Fax:
Practice Address - Street 1:9500 RAY WHITE RD STE 200
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244-9105
Practice Address - Country:US
Practice Address - Phone:817-242-5661
Practice Address - Fax:817-898-4213
Is Sole Proprietor?:No
Enumeration Date:2018-09-13
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP140301363L00000X, 363LF0000X
FLARNP9358360363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner