Provider Demographics
NPI:1811991367
Name:LEVARO, FERNANDO PANO (MD)
Entity type:Individual
Prefix:DR
First Name:FERNANDO
Middle Name:PANO
Last Name:LEVARO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:FERNANDO
Other - Middle Name:
Other - Last Name:LEVARO-PANO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1200 BINZ ST
Mailing Address - Street 2:# 100
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-6944
Mailing Address - Country:US
Mailing Address - Phone:713-520-1210
Mailing Address - Fax:713-400-8302
Practice Address - Street 1:1200 BINZ ST
Practice Address - Street 2:# 100
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-6944
Practice Address - Country:US
Practice Address - Phone:713-520-1210
Practice Address - Fax:713-400-8302
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL24122082S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the Hand
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX151524902Medicaid
TXH57402Medicare UPIN
TX8B7571Medicare ID - Type Unspecified