Provider Demographics
NPI:1912993650
Name:LEVY, MARIA DEL PILAR CONCEPCION (MD)
Entity Type:Individual
Prefix:
First Name:MARIA DEL PILAR
Middle Name:CONCEPCION
Last Name:LEVY
Suffix:
Gender:F
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:PO BOX 733784
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-3784
Mailing Address - Country:US
Mailing Address - Phone:682-885-1855
Mailing Address - Fax:682-885-7347
Practice Address - Street 1:1400 S MAIN ST STE 400
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-4913
Practice Address - Country:US
Practice Address - Phone:817-702-1307
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD38309208000000X
TXM5328208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX137345810OtherCSHCN GROUP
TX184850902OtherCSHCN
TN5440031Medicaid
TX184850901Medicaid
TX140442852OtherMEDICAID GROUP
TX8F0039OtherBCBS
TN5440031Medicaid