Provider Demographics
NPI:1598787814
Name:LEVY, ALFRED E (MD)
Entity Type:Individual
Prefix:DR
First Name:ALFRED
Middle Name:E
Last Name:LEVY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4708 ALLIANCE BLVD
Mailing Address - Street 2:SUITE 550
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5340
Mailing Address - Country:US
Mailing Address - Phone:469-800-6140
Mailing Address - Fax:469-800-6145
Practice Address - Street 1:4708 ALLIANCE BLVD
Practice Address - Street 2:SUITE 550
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5340
Practice Address - Country:US
Practice Address - Phone:469-800-6140
Practice Address - Fax:469-800-6145
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF3207207Q00000X, 207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1164337-04Medicaid
TX116433702Medicaid
TX080077787Medicare PIN
TXC18377Medicare UPIN
TX87W704Medicare PIN
TXTXB143952Medicare PIN