Individual
LENA MARIE LEVINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
1250 8TH AVE STE 600, FORT WORTH, TX 76104-4121
(817) 702-9100
Mailing address
PO BOX 99335, FORT WORTH, TX 76199-0335
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
2094
TX
213ES0103X
Foot & Ankle Surgery Podiatrist
T312011
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
337722801
—
TX
01
—
8EJ945
BCBS
TX
01
—
P01447524
RAILROAD MEDICARE
TX
Enumeration date
06/27/2011
Last updated
12/18/2023
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