Individual
MARYGRACE C LEVEILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4360 N JOSEY LN, CARROLLTON, TX 75010-4602
(972) 939-8294
(214) 731-0240
Mailing address
9229 LYNDON B JOHNSON FWY, SUITE 250, DALLAS, TX 75243-3405
(972) 739-3097
(972) 739-2673
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
533547
TX
363LA2100X
Acute Care Nurse Practitioner
Primary
AP109451
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
175724701
—
TX
05
—
175724702
—
TX
Enumeration date
07/14/2006
Last updated
09/27/2022
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