Provider Demographics
NPI:1679547558
Name:LEVEY, DAVID STANLEY (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:STANLEY
Last Name:LEVEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:622 CINNAMON OAK
Mailing Address - Street 2:
Mailing Address - City:SHAVANO PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78230-5649
Mailing Address - Country:US
Mailing Address - Phone:210-492-0050
Mailing Address - Fax:210-492-0060
Practice Address - Street 1:622 CINNAMON OAK
Practice Address - Street 2:
Practice Address - City:SHAVANO PARK
Practice Address - State:TX
Practice Address - Zip Code:78230-5649
Practice Address - Country:US
Practice Address - Phone:210-492-0050
Practice Address - Fax:210-492-0060
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2010-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ48922085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX119324508Medicaid
TX8K9515Medicare PIN