Provider Demographics
NPI:1528218831
Name:AARON M. LEVINE, M.D., P.A.
Entity Type:Organization
Organization Name:AARON M. LEVINE, M.D., P.A.
Other - Org Name:AARON M. LEVINE, M.D.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:M
Authorized Official - Last Name:LEVINE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-484-8123
Mailing Address - Street 1:11914 ASTORIA BLVD STE 540
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77089-6050
Mailing Address - Country:US
Mailing Address - Phone:281-484-8123
Mailing Address - Fax:281-484-5184
Practice Address - Street 1:11914 ASTORIA BLVD STE 540
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77089-6050
Practice Address - Country:US
Practice Address - Phone:281-484-8123
Practice Address - Fax:281-484-5184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-23
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF3535208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX128224601Medicaid
TX128224601Medicaid
TXG505Medicare PIN