Provider Demographics
NPI:1669787677
Name:LEVACK, ERIKA SINCLAIR
Entity type:Individual
Prefix:MRS
First Name:ERIKA
Middle Name:SINCLAIR
Last Name:LEVACK
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:ERIKA
Other - Middle Name:ORPHEA
Other - Last Name:SINCLAIR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:4206 AVENUE C
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78751-3707
Mailing Address - Country:US
Mailing Address - Phone:512-373-3555
Mailing Address - Fax:
Practice Address - Street 1:1313 RED RIVER ST
Practice Address - Street 2:SUITE A1
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78701-1943
Practice Address - Country:US
Practice Address - Phone:512-324-7036
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-13
Last Update Date:2013-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX787094363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health