Provider Demographics
NPI:1528209772
Name:LEVY, GAL (MSC CCC-SLP)
Entity Type:Individual
Prefix:
First Name:GAL
Middle Name:
Last Name:LEVY
Suffix:
Gender:M
Credentials:MSC CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6589 SCOTTSDALE WAY
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-4015
Mailing Address - Country:US
Mailing Address - Phone:214-995-6444
Mailing Address - Fax:214-618-8884
Practice Address - Street 1:6589 SCOTTSDALE WAY
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-4015
Practice Address - Country:US
Practice Address - Phone:214-995-6444
Practice Address - Fax:214-618-8884
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-18
Last Update Date:2014-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX102064235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist