Individual
TAYLOR DEAN LEAVITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3038 BLUE JAY LN, MIDLOTHIAN, TX 76065-8704
(208) 989-1040
Mailing address
18703 CREEK FOREST DR, MANVEL, TX 77578-5289
(208) 989-1040
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
BP10030398
TX
Other
Enumeration date
04/18/2022
Last updated
09/20/2022
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