Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 28811 | TX |
N | 1223G0001X | General Practice | DE00007394 | WA |
N | 213EG0000X | General Practice | DE00007394 | WA |
NPI | 1003986977 |
---|---|
Provider Name | Dr. Jonathan A. Levey |
First Address | Austin, TX 78752-2055 |
Second Address | Georgetown, TX 78633-1352 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2006 |
Last Update Date | 25/07/2013 |