Provider Demographics
NPI:1497845184
Name:LEVY, NAOMI JAEGER (MD)
Entity Type:Individual
Prefix:DR
First Name:NAOMI
Middle Name:JAEGER
Last Name:LEVY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6700 WEST LOOP S
Mailing Address - Street 2:300
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-4104
Mailing Address - Country:US
Mailing Address - Phone:713-218-0808
Mailing Address - Fax:
Practice Address - Street 1:6700 WEST LOOP S
Practice Address - Street 2:300
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-4104
Practice Address - Country:US
Practice Address - Phone:713-988-4334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL4526208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX161085901Medicaid