Provider Demographics
NPI:1578981569
Name:LEVINE, GWENDOLYN (DVM)
Entity Type:Individual
Prefix:
First Name:GWENDOLYN
Middle Name:
Last Name:LEVINE
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:TAMU 4467
Mailing Address - Street 2:COLLEGE OF VETERINARY MEDICINE AND BIOMEDICAL SCIENCES
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77843-4467
Mailing Address - Country:US
Mailing Address - Phone:979-845-2351
Mailing Address - Fax:
Practice Address - Street 1:TAMU 4467
Practice Address - Street 2:COLLEGE OF VETERINARY MEDICINE AND BIOMEDICAL SCIENCES
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77843-4467
Practice Address - Country:US
Practice Address - Phone:979-845-2351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-07
Last Update Date:2014-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10418174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian