Provider Demographics
NPI:1952344061
Name:LEVY, ROBERT LEWIS (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:LEWIS
Last Name:LEVY
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 1:6300 W. PARKER ROAD
Mailing Address - Street 2:G22, M.O.B. 2
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093
Mailing Address - Country:US
Mailing Address - Phone:972-394-0200
Mailing Address - Fax:972-492-3390
Practice Address - Street 1:6300 W. PARKER ROAD
Practice Address - Street 2:G22, M.O.B. 2
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093
Practice Address - Country:US
Practice Address - Phone:972-394-0200
Practice Address - Fax:972-492-3390
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2013-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG4638207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX046898501Medicaid
TX046898501Medicaid
88C066Medicare ID - Type Unspecified
C18375Medicare UPIN